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This brief discusses key Medicaid policy changes included in CMS budget neutrality guidance and identifies open questions about how the policy changes may be clarified and how they may affect states with existing 1115 waivers or states interested in applying for new ones.
KFF's interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies.
Section 1115 Medicaid waivers can allow states to test new approaches in Medicaid that differ from what is required by federal law. This page tracks approved and pending waiver provisions (including expansions and restrictions) related to eligibility, benefits, and social determinants of health and other delivery system reforms.
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.
The federal government continues to focus on addressing fraud, waste, and abuse in Medicaid, with much of the attention focused on home care services. This issue brief provides new information about Medicaid home care programs’ use of program integrity tools, based on findings from KFF’s 50-state survey of Medicaid home care program officials.
In all years since 2016, there have been at least 0.5 million people on waiting lists or interest lists for Medicaid home care, with a total of almost 650,000 in 2026. This data note provides new information about these waiting lists based on findings from KFF’s 50-state survey of Medicaid home care program officials.
This page tracks recent state actions to extend Medicaid postpartum coverage, including approved and pending 1115 waivers, legislation that will require the state to seek federal approval through a SPA or 1115 waiver, submitted and approved SPAs, and coverage financed solely with state funds.
Nebraska is the first state to announce it plans to begin enforcing Medicaid work requirements early, starting May 1, 2026. Initial reports from the state during its recent January Medicaid Advisory Committee (MAC) meeting and data from KFF’s Medicaid work requirements tracker provide early insights into how Nebraska is preparing for implementation.
In this brief on Medicaid issues to watch for 2026, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.
After failed Senate votes late last year and no subsequent bipartisan agreement, the enhanced premium tax credits expired as of January 1. Some states, particularly those operating State-Based Marketplaces (SBMs), have been preparing for this possibility for months and are moving to blunt the impact on consumers by implementing their own state-funded subsidies and implementing other programs aimed at stabilizing the cost of unsubsidized premiums.
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