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Number of States Affected by Key Medicaid Provisions in the 2025 Reconciliation Law

Which States Will Be Affected by Key Medicaid Provisions in the 2025 Reconciliation Law?

The 2025 reconciliation law makes sweeping changes to Medicaid that will affect every state through key eligibility and financing changes, including new work requirements, immigrant eligibility restrictions, and changes to provider taxes and state directed payments. This issue brief explains which states will be affected by each of these key provisions.

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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  • Unintended Consequences: The Potential Impact of Medicare Part D on Dual Eligibles with Disabilities in Medicaid Work Incentive Programs

    Report

    Individuals with disabilities who are eligible for both Medicare and Medicaid must also shift to a Medicare prescription drug benefit in 2006. This report analyzes how younger dual eligibles in Kansas enrolled in work incentive programs differ than other Medicare enrollees in the types of drugs they use and how much drug spending they have to better assess the impact of the Medicare drug benefit on this population. Report (.pdf)

  • Medicaid: Addressing the Future

    Event

    Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, testified before the U.S. Senate Special Committee on Aging on the future of Medicaid and its role for low-income Americans, particularly the elderly. Testimony (.pdf)

  • National Survey of the Public’s Views About Medicaid

    Poll Finding

    National Survey of the Public's Views About Medicaid This national survey of the public reveals that Americans view the Medicaid program positively and are reluctant to see state and federal cuts to the program. The survey also asked the public about their knowledge of the Medicaid program. Chartpack Toplines

  • National Survey of the Public’s Views About Medicaid – Chartpack

    Report

    This chartpack provides key findings from the national survey of the public on their views about Medicaid. The survey was conducted in April and May of 2005. The survey includes findings on Americans' personal experience with Medicaid, their knowledge of the program, and their opinion about the program's coverage and funding by the state and federal government. Chartpack (.pdf)

  • The Latest Data on Mandatory and Optional Populations and Benefits in Medicaid

    Report

    With discussions on restructuring Medicaid occurring in state capitols and Washington, two new reports provide the latest data on how much of Medicaid's spending is for covering mandatory versus optional populations and services. The analysis shows that although optional populations account for 29 percent of Medicaid enrollment, 60 percent of all Medicaid spending (whether for mandatory or optional populations) is optional and 86 percent of optional spending is for the elderly or individuals with disabilities.…

  • Medicaid:  An Overview of Spending on “Mandatory” vs. “Optional” Populations and Services

    Issue Brief

    Medicaid: An Overview of Spending on "Mandatory" vs. "Optional" Populations and Services This issue brief provides an overview of Medicaid’s optional beneficiaries and services. The brief demonstrates that although “optional” populations account for only 29 percent of Medicaid enrollment, 60 percent of all Medicaid expenditures for both “mandatory” and “optional” populations are “optional,” and the majority of these (86 percent) pay for services provided to the elderly and disabled. Issue Paper (.pdf)

  • Medicaid Enrollment and Spending by “Mandatory” and “Optional” Eligibility and Benefit Categories

    Report

    Medicaid Enrollment and Spending by "Mandatory" and "Optional" Eligibility and Benefit Categories This report presents new estimates of the proportion of Medicaid beneficiaries and spending that is mandatory and optional to promote an increased understanding of how Medicaid restructuring proposals might affect the various groups and services covered by the program. Report (.pdf)

  • Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline: June 2004 – December 2006 Key Dates

    Report

    Key Implementation Dates for the Medicare Prescription Drug Benefit This timeline presents important dates and deadlines of key implementation activities related to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It runs from the beginning of 2005 through the end of 2006, the first year of the new Medicare drug benefit. Some of these dates are defined in the MMA statute, while others are from the final rule issued by the Centers…

  • Stresses to the Safety Net:  The Public Hospital Perspective

    Report

    The nation’s safety net financing is fragmented; consequently, providers must knit together resources from many different funding sources to create a stream of revenue to cover the costs of providing a very broad range of services. This report describes those sources of revenue, documenting that nearly 40% of all safety net revenues are from Medicaid. The report also describes challenges that safety net hospitals and health systems are experiencing as they attempt to rebound from…