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Medicaid Midterm Election Update

Midterm Election Update: Medicaid Changes

Major federal changes to Medicaid eligibility and financing from the 2025 reconciliation law are coming, including new work requirements that will affect millions of Medicaid enrollees. KFF’s fact sheet provides an overview of what has changed, what is still ahead, and what the public thinks about Medicaid heading into the midterms.

There were 72.9 million people enrolled in Medicaid/CHIP nationally in July, and enrollment declined by 5.1 million or 7% from July 2025 through July 2026.

Medicaid/CHIP Monthly Enrollment Tracker

KFF's tracker presents the most recent Medicaid monthly enrollment data. There were 72.9 million people enrolled in Medicaid/CHIP nationally in July, and enrollment declined by 5.1 million or 7% from July 2025 through July 2026.

Medicaid work requirements

Nebraska Renewal Outcomes Among Individuals Subject to Medicaid Work Requirements

Early Medicaid Work Requirement Insights From Nebraska

This brief describes the verification process for Medicaid work requirements in Nebraska and examines early data on outcomes for individuals subject to work requirements. Among Medicaid enrollees renewing coverage under Nebraska's work requirements, 93% met the requirements or qualified for an exemption —while 7% lost coverage.

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. The Congressional Budget Office estimates that the 2025 reconciliation law will increase the number of people who are uninsured in 2034 by 10 million. Coverage losses from Medicaid work requirements account for over half, or 5.3 million, of the increase in the number of uninsured.

understanding medicaid

Medicaid Financing: The Basics

Medicaid represents $1 out of every $5 spent on health care in the U.S. This brief examines key questions about Medicaid financing and how it works.

Medicaid and Provider Taxes

This brief explores how rules governing provider taxes are changing because of the 2025 reconciliation law and the regulations implementing that law, and summarizes which changes may affect each state.

5 Key Facts About Medicaid and Hospitals

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

Medicaid home Care

Medicaid Home Care/HCBS Survey

Since 2001, KFF has administered regular surveys of states about their Medicaid home- and community-based services (HCBS) programs. The survey is sent to officials administering Medicaid HCBS programs in all 50 states and the District of Columbia.

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  • How the Republican Health Agenda Could Play Out

    From Drew Altman

    In this Wall Street Journal Think Tank column Drew Altman discusses how Republicans will assume ownership of health care’s policy and political problems as they assume control, and how that may affect their plans for the Affordable Care Act, Medicaid and Medicare.

  • The Health Care Plan Trump Voters Really Want

    From Drew Altman

    In a New York Times op-ed, Drew Altman draws on observations from focus groups in rust belt states of people in the Affordable Care Act (ACA) marketplaces who voted for President-elect Trump and say they may not like their coverage under the ACA but could like Republican replacement plans even less.

  • Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion

    Interactive

    As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2017 ACA marketplace health plan and the political party of each district’s representative as of October 2017. The analysis also includes maps charting the total number of people enrolled under the ACA Medicaid expansion in…

  • New Interactive Map with Local Data: Estimated 2016 ACA Marketplace Enrollment by Congressional District

    News Release

    As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, a new interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January. The analysis also includes maps charting by state the total number of people enrolled under the ACA Medicaid…

  • Data Note: Estimated Medicaid Savings in the House Budget Resolution from March 2016

    Issue Brief

    While the current Budget Resolution under consideration will set the framework for a repeal of the ACA, the Budget Resolution that passed in March 2016 provides insight into other Medicaid cuts that could be considered by Congress later this year. This Data Note examines proposed reductions in federal Medicaid funding under the March 2016 House Budget Resolution.

  • Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs, 2014-2017

    Issue Brief

    Although the outpatient drug benefit accounts for only 6% of total Medicaid spending, drug spending has increased by double digits in recent years, and is expected to grow faster than most other Medicaid services in the next 10 years. This issue brief examines drug spending and utilization from 2014 through 2017 by drug group, brand and generic status, and biologic status to understand the causes for this increase in spending.

  • An Overview of State Approaches to Adopting the Medicaid Expansion

    Issue Brief

    State approaches to adopting the Affordable Care Act’s Medicaid expansion have varied greatly by state based on state law, the political context, or other factors. While it does not cover how every state has enacted the Medicaid expansion, this issue brief highlights some of the different approaches states have taken to adopt the Medicaid expansion. Each state’s circumstances are unique, and the actions taken by one state may not apply to another state’s circumstances.