State Budgets

This issue brief examines Medicaid expansion enrollment and Medicaid spending in expansion and non-expansion states and describes the characteristics of adults covered by the Medicaid expansion.

As Congress weighs potential cuts in federal Medicaid spending through budget reconciliation, one option under consideration is to limit the use of state taxes on providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe states’ current provider taxes and the federal rules governing them.

This brief explores the magnitude of the potential federal Medicaid funding cuts under the House budget resolution. This brief puts the $880 billion in cuts in context by comparing the size of the cuts to states’ tax revenues, spending on education, and the number of Medicaid enrollees covered for that cost.

As Congress considers ways to cut Medicaid spending to help finance the extension of federal tax cuts, a new KFF analysis finds that imposing a cap on federal spending per Medicaid enrollee—known as a “per capita cap”—could trigger a decrease in federal Medicaid spending over a 10-year period of $532…

This analysis examines the potential impacts on states, Medicaid enrollees, and providers of implementing a per capita cap on federal Medicaid spending, which is one proposal that has been discussed in Congress. Such a plan could decrease federal Medicaid spending by $532 billion to almost $1 trillion over a 10-year period, depending on how states respond. An estimated 15 million people could lose Medicaid coverage by 2034.

A new KFF analysis finds that a congressional proposal to significantly cut federal spending on the Affordable Care Act’s Medicaid expansion could reduce total Medicaid spending by up to nearly one-fifth, or $1.9 trillion, over a 10-year period, and end Medicaid coverage for as many as 20 million people.The impacts…

This analysis examines the potential impacts on states and Medicaid enrollees of eliminating the 90% federal match rate for the Affordable Care Act (ACA) expansion. Eliminating the federal match rate for adults in the Medicaid expansion could reduce Medicaid spending by nearly one-fifth ($1.9 trillion) over a 10-year period and up to nearly a quarter of all Medicaid enrollees (20 million people) could lose coverage.

Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.