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Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, 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.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid Work Requirements

Tracking Medicaid Work Requirements: u003cbru003eData and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

understanding medicaid

Medicaid Financing

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 care. This brief examines key questions about Medicaid financing and how it works.

Medicaid and Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

5 Facts: Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

Medicaid Home Care in 2025

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services”) is, who is covered, and what services were available in 2025.

5 Facts: Medicaid Program Integrity

This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage

  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.

  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.

  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Integrating Care for Dual Eligibles: What Do Consumers Want?

    Event Date:
    Event

    Many deficit reduction plans have recognized the need to improve care for the 9 million beneficiaries dually eligible for Medicare and Medicaid. How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are Health and Human Services initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kind of programs are currently available? What do consumers think about different ways of getting care? What lessons for program design can…

  • Money Follows the Person: A 2011 Survey of Transitions, Services and Costs

    Issue Brief

    With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. A total…

  • Performance Measurement Under Health Reform: Proposed Measures For Eligibility and Enrollment Systems and Key Issues and Trade-offs to Consider

    Issue Brief

    The adoption of new eligibility and enrollment requirements under the Affordable Care Act (ACA) provides states and the federal government an important opportunity to implement a meaningful set of performance measures for eligibility and enrollment systems. Performance measures could be used at the federal level to assess state performance in meeting the ACA’s eligibility and enrollment goals, while states could use measures for program management and quality improvement. This brief seeks to inform the development…

  • The Texas Health Care Landscape

    Report

    This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • Case Study: Georgia’s Money Follows the Person Demonstration

    Issue Brief

    This brief reports on a case study of Georgia's Money Follows the Person (MFP) demonstration program, describing key features of the program and highlighting recent program experiences. The Georgia Department of Community Health (DCH) implemented the program in September 2008. In 2005, before the demonstration began, Georgia’s long-term care expenditures were $1.5 billion, with 70 percent devoted to institutional long-term care and 30 percent on home and community-based services (HCBS). One goal of the demonstration…

  • Changes in Health Insurance Coverage in the Great Recession, 2007-2010

    Issue Brief

    This issue brief examines changes in health insurance coverage over the last decade, with a focus on how changes in the economy, particularly during the "Great Recession" of 2007 to 2009, have affected coverage and the number of uninsured. The paper finds that the number of uninsured grew substantially during the first recession of the decade, increasing by 5 million people from 2000 to 2004; increased more slowly during the brief recovery, growing by 2.1…

  • Georgia’s Money Follows the Person Program: Helping People Move Back Home

    Issue Brief

    This brief profiles several Georgia residents who have participated in the state's Money Follows the Person demonstration program, which helps transition people from institutional long-term care back into their homes or the community. It is part of a larger package of resources examining the Money Follows the Person program. Profiles (.pdf)

  • The Texas Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • California and Texas: Section 1115 Medicaid Demonstration Waivers Compared

    Fact Sheet

    This fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010. Both waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will…

  • Webcast: New CMS Estimates of State-by-State Health Expenditures

    Event Date:
    Event

    The Kaiser Family Foundation held a live interactive webcast on December 7, 2011, to discuss trends in state health care expenditures and the implications for national and state efforts to constrain health care costs. The webcast examines new state-by-state estimates of public and private health spending from the Centers for Medicare and Medicaid Services (CMS) published in the online journal, Medicare and Medicaid Research Review. An expert panel offers perspectives on the trends within and…