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This 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.
On July 11, CMS notified states that, going forward, it does not anticipate approving new 1115 demonstration workforce initiatives or extending existing waivers. Such changes may limit states’ abilities to pursue initiatives investing in the Medicaid workforce.
This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10M in 2034 and rise to over 14M if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.
This brief examines state policies related to prior authorization processes in Medicaid managed care and includes findings about how states approach prior authorization decision timeframes, electronic denial notices, and access to external medical reviews, all as of July 1, 2024.
On July 4, President Trump signed into law a budget reconciliation package once called the “One Big, Beautiful Bill” that includes significant changes to the Medicaid program. This issue brief provides an overview of the Medicaid work requirement provisions.
Under 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.
This 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.
In 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?”
This brief uses 2021 Medicaid claims data to examine utilization among Medicaid expansion adults and estimate how much cost sharing these enrollees could be required to pay under the new requirement if all states imposed the maximum cost sharing amounts. This is an illustrative analysis intended to describe which enrollees may be subject to the most cost sharing under the new provisions rather than estimate exactly what expansion enrollees may actually pay.
To understand the impact of Medicaid work requirements included in the budget reconciliation bill being debated in Congress, KFF has undertaken two different analyses using different data sources. Using 2023 data from the Survey of Income and Program Participation, this analysis looks at the share of adults who work at least 80 hours per month, the reasons some do not, and how consistently individuals meet the requirement over a six-month period.
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