A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes
This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
View the Latest: Prescription Drugs
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State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes
News ReleaseAs states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
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Developments in Prescription Drug Pricing under the Second Trump Administration
Event Date:EventThree experts joined Larry Levitt, executive vice president for health policy at KFF, for a discussion about the latest developments in prescription drug pricing and what they mean for drug manufacturers, patients and public and private health insurance programs.
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Perspectives from Employers on the Costs and Issues Associated with Covering GLP-1 Agonists for Weight Loss
Issue BriefWhile more large employers are covering GLP-1 drugs for weight loss, KFF's conversations with employers highlight concerns about the cost of these medications. Many of these employers have considered scaling back coverage of GLP-1 agonists for weight loss, or in some cases, employers are adding or strengthening coverage requirements.
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Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000, with Workers Paying $6,850 Toward Premiums Out of Their Paychecks
News ReleaseFamily premiums for employer-sponsored health insurance reached an average of $26,993 this year, KFF’s annual benchmark health benefits survey of large and smaller employers finds. On average, workers contribute $6,850 annually to the cost of family coverage, with employers paying the rest.
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The Semi-Sad Prospects for Controlling Employer Health Care Costs
From Drew AltmanIn a commentary on KFF’s 27th employer health benefits survey, President and CEO Dr. Drew Altman discusses the obstacles employers face trying to control their health care costs, and the reasons why they’ve never been meaningful supporters of government cost-containment efforts. He predicts that premium increases expected next year could lead to a new wave of higher deductibles and other forms of cost sharing for the 155 million Americans who rely on employer coverage. Read the column here.
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2025 Employer Health Benefits Survey
ReportThis annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year's report also looks at how employers are approaching coverage of GLP-1 drugs for weight loss, including their concerns about utilization and cost.
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People with Medicare Will Face Higher Costs for Some Orphan Drugs Due to Changes in the New Tax and Budget Law
Issue BriefThis brief analyzes changes in the new tax and budget reconciliation law that modify which drugs will be selected for Medicare drug price negotiation, which will lead to higher Medicare spending and higher costs for beneficiaries who take these medications.
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Examining Short-Term Limited-Duration Health Plans on the Eve of ACA Marketplace Open Enrollment
Issue BriefAs Marketplace Open Enrollment nears, policy changes could leave millions of people facing substantially higher premiums and coverage loss, which could lead more consumers to purchase less expensive and less comprehensive coverage through short-term health plans. KFF analyzes short-term health policies sold by nine large insurers in 36 states, examining premiums, cost sharing, covered benefits, and coverage limitations and comparing them to ACA Marketplace plans.
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Is it Too Late for ACA Insurers to Change Their Premiums?
Quick TakeAffordable Care Act Marketplace insurers are raising premiums by an average of 18% next year, due in part to the expiring enhanced premium tax credits. Even if the credits are extended in shutdown negotiations, it is unlikely that insurers will have time to revise premiums, though the credits would still offer enrollees relief from them.