Medicaid Enrollment & Spending Growth: FY 2025 & 2026
This brief analyzes Medicaid enrollment and spending trends for FY 2025 and FY 2026, based on data provided by state Medicaid directors as part of the 25th annual survey of Medicaid directors.
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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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A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes
ReportThis report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
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State Awards From Most of the Rural Health Fund Could Vary Only Modestly Despite Large Differences in Rural Needs
Issue BriefThis brief provides estimates of how $37.5 billion of the $50 billion rural health fund could be distributed across states if all states are approved for funding. Awards from the $37.5 billion could range from an estimated $550 million (in Rhode Island) to just over $1 billion (in Texas) over five years if all states were approved for funding. These differences are relatively modest compared to the wide variation across states in rural health needs.
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Status of State Medicaid Expansion Decisions
InteractiveThis page displays an interactive map of the current status of state decisions on the Affordable Care Act's Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.
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A Closer Look at the $50 Billion Rural Health Fund in the New Reconciliation Law
Issue BriefThe new reconciliation law includes a $50 billion rural health fund. This brief describes the rural health fund, explains what the law says about the allocation of funds, and highlights outstanding questions about how the funds will be distributed across and within states to pay rural hospitals and for other purposes.
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How Might Federal Medicaid Cuts in the Enacted Reconciliation Package Affect Rural Areas?
Policy WatchUnder the reconciliation package, federal Medicaid spending in rural areas is estimated to decline by $137 billion, more than the $50 billion appropriated for the rural health fund.
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Allocating CBO’s Estimates of Federal Medicaid Spending Reductions Across the States: Enacted Reconciliation Package
Issue BriefThis analysis allocates the CBO’s estimated reduction in federal spending in the enacted reconciliation package across states based on KFF’s state-level data and where possible, prior modeling work; and shows the federal spending reductions relative to KFF’s projections of federal spending by state under current law.
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What to Make of the $50 Billion Rural Hospital Grants Program
From Drew AltmanIn his latest Beyond the Data column, KFF President and CEO Dr. Drew Altman examines the controversial rural hospital grant program, noting “Will the new $50 billion rural hospital grant program in the big Republican tax and spending law just amount to a bunch of ribbon cutting and big check ceremonies, or will it help rural hospitals offset coming Medicaid cuts, help them in general, or all of the above?”
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Can Democrats Make the Medicaid and ACA Cuts Their Winning Political Issue Before People Feel the Cuts?
From Drew AltmanIn his latest Beyond the Data column, President and CEO Dr. Drew Altman discusses whether Democrats can make the Medicaid and ACA cuts a winning political issue before the midterm elections and before most people feel the cuts.