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What to Watch

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.

Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

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.

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.

The Essentials

  • 5 Facts: Immigrants and Medicaid

    This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.

  • 5 Facts: Medicaid and Hospitals

    This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.

  • Medicaid Financing: The Basics

    Medicaid is a 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.

  • 5 Facts: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 5 Facts: Medicaid and Nursing Facilities

    The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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  • Insights on Transitioning From Medicaid to the New Medicare Prescription Drug Benefit

    Report

    The Kaiser Commission on Medicaid and the Uninsured convened a focus group of state Medicaid officials in November 2005 to discuss the impact of the new Medicare drug program on states and Medicaid enrollees. State insights on the transition of dual eligibles and some beneficiary experiences are discussed in new material and an audio briefing.

  • Private Long-Term Care Insurance: A Viable Option for Low and Middle-Income Seniors?

    Issue Brief

    In the Deficit Reduction Act of 2005, the federal government made it harder for individuals to qualify for Medicaid nursing home benefits by increasing penalties on individuals who have transferred assets for less than fair market value during the past five years and by making individuals with home equity above $500,000 ineligible for nursing home…

  • Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    This updated fact sheet describes the nearly 8.9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and what the new health reform law may mean for them. Fact Sheet (.

  • Medicaid Spending and Enrollment: State and National Data Update

    Report

    This series of tables provides recent data on state-by-state and national Medicaid spending and enrollment. Using the latest federal information sources available, the first set of tables contains information on Medicaid spending by service using data from the Centers on Medicaid and Medicare Services (CMS) Form 64 for Federal Fiscal Year (FFY) 2004.

  • SCHIP Reauthorization: Key Questions in the Debate – A Description of New Administrative Guidance and the House and Senate Proposals – Issue Brief

    Issue Brief

    SCHIP Reauthorization: Key Questions in the Debate – A Description of New Administrative Guidance and the House and Senate Proposals The U.S. Senate and the House of Representatives have approved legislation to reauthorize the State Children's Health Insurance Program (SCHIP), which covers six million low-income children today.

  • Trends in Medicaid Physician Fees, 2003-2008

    Fact Sheet

    This study, published in a Health Affairs Web exclusive, provides the first national and state-by-state update of Medicaid physician fees since 2003. Medicaid has historically reimbursed physicians under fee-for-service at levels below what Medicare and private health insurers would pay for the same services.

  • Health Reform Opportunities: Improving Policy for Dual Eligibles

    Issue Brief

    As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare.

  • State Medicaid Coverage of Perinatal Services: Summary of State Survey Findings

    Issue Brief

    The report examines state Medicaid program policies regarding coverage of pregnancy-related services. It details state-level Medicaid eligibility and enrollment policies for pregnant women, as well as scope of coverage for prenatal and screening services, delivery and post-partum care, educational classes and support services.