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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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  • Medicaid’s Role in Behavioral Health

    Other Post

    This infographic highlights Medicaid's role in facilitating access to behavioral health treatment and the impact of potential reductions in federal Medicaid financing on behavioral health coverage and access to services.

  • Brief Examines Per Enrollee Medicaid Spending for Seniors and People with Disabilities, Which Varies Greatly By State

    News Release

    Medicaid coverage of acute and long-term care for more than 6 million low-income seniors and 10 million nonelderly people with disabilities accounts for nearly two-thirds of overall Medicaid spending, although such enrollees represent less than a quarter of people on Medicaid.  Much of Medicaid’s spending on seniors and people with disabilities also depends on state decisions about whom to cover and which services to pay for, which is a big reason why Medicaid spending per…

  • Medicaid Waiver Requests in Wisconsin and Maine Seek to Impose Work Requirements and Time Limits for Beneficiaries

    News Release

    A new issue brief from the Kaiser Family Foundation highlights proposed changes to Medicaid programs in Wisconsin and Maine that include work requirements and time limits in both states, as well as drug screenings for some beneficiaries in Wisconsin. The waiver authority sought by both states would impose welfare-like restrictions and include a number of provisions that have never been approved for traditional, non-Medicaid expansion populations, such as locking beneficiaries out of coverage for failure…

  • No, Medicaid Isn’t Broken

    From Drew Altman

    With Medicaid about to be a focal point of debate in the Senate, Drew Altman's Axios column looks at why the idea that the program is broken is more urban legend than fact.

  • Kaiser Health Tracking Poll – May 2017: The AHCA’s Proposed Changes to Health Care

    Report

    With House Republicans passing the American Health Care Act (AHCA), their plan to repeal and replace the Affordable Care Act (ACA), and the Senate currently debating the plan and discussing their own approach, the latest tracking poll finds more view the ACA favorably than view the AHCA favorably. The poll examines attitudes towards specific provisions included in the replacement plan and how the public thinks the replacement plan will affect their own health care.

  • The Other Implication of the CBO Report: Election-Year Pain

    From Drew Altman

    In this Axios column, Drew Altman lays out how the “political pain” from the American Health Care Act would play out over the next two election cycles if passed in its current form, based on the Congressional Budget Office’s analysis of the House-passed bill.

  • Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

    News Release

    Public Grows More Pessimistic About How Repeal Will Affect Them Personally Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill or not pass it all, finds the latest Kaiser Health Tracking Poll. Three in 10 (31%) of the public hold favorable views of the American…

  • Brief Examines the Olmstead Decision’s Role In Community Integration for People With Disabilities Under Medicaid

    News Release

    As the 15th anniversary of the Supreme Court’s Olmstead decision approaches this month, a new brief from the Kaiser Family Foundation examines the legacy of the landmark civil rights ruling that the institutionalization of people with disabilities is illegal discrimination under the Americans with Disabilities Act. The brief, Olmstead’s Role In Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision, revisits the historic case and examines legal developments…

  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion Decisions in the South

    Other Post

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the South remain…

  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…