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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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  • Medicaid’s Federal-State Partnership: Alternatives for Improving Financial Integrity – Summary of Issues, Approaches, and Alternatives for Reform

    Report

    In this report from the Kaiser Commission on Medicaid and the Uninsured, Penny Thompson, former deputy director for the Center for Medicaid and State Operations, used existing models from the private sector and other government programs to assess Medicaid’s financial management and to develop options for improvement. This table summarizes the report’s findings. Chart (.pdf) Report

  • Medicaid Financing and Fiscal Management:  A Discussion of the Current Federal-State Partnership and Program Integrity

    Other Post

    Medicaid Financing and Fiscal Management: A Discussion of the Current Federal-State Partnership and Program Integrity The Kaiser Commission on Medicaid and the Uninsured will host a discussion for reporters on Tuesday, March 2, 2004 to discuss Medicaid financing and fiscal management and related proposals for change. Reporters in the area are invited to participate from our office; all reporters are invited to participate via conference call. For more information, call 202-654-1313. Medicaid's Federal-State Partnership: Alternatives…

  • Medicaid and Block Grant Financing Compared

    Issue Brief

      - Issue Brief State and federal budget pressures, rising health care costs, and new waiver initiatives have promoted debate over restructuring Medicaid at the federal and state level. Questions about how Medicaid is financed are central to this debate. This paper compares the current Medicaid financing system to a generic block grant financing system to illustrate the key differences in the structure and incentives of these alternative approaches. Issue Brief (.pdf)  

  • Medicaid’s Federal-State Partnership: Alternatives for Improving Financial Integrity

    Report

    - Report As the federal government increases its scrutiny of state financing of the Medicaid program, this paper, authored by a former CMS official, evaluates the existing financial management of the Medicaid program. Using existing models from the private sector and the government, the paper identifies alternatives to improve Medicaid's financial management without changing Medicaid's existing financing structure. The alternatives would reduce the Medicaid program's exposure to questionable practices, help control federal costs, and make…

  • State Perspectives on Medicaid Long-term Care: Report from a July 2003 State Forum

    Report

    This report summarizes discussions on Medicaid and long-term care at a forum with state officials held by the Kaiser Commission on Medicaid and the Uninsured in July of 2003. The forum, conducted by the National Academy of State Health Policy, addressed issues including Medicaid's role in long-term care, state fiscal crises and cost-containment strategies, and how state long-term care programs are evolving. Report (.pdf)

  • SCHIP-Enrolled Children with Special Health Care Needs

    Report

    : An Assessment of Coordination Efforts Between State SCHIP and Title V Programs This study explores how the State Children’s Health Insurance Program serves children with special needs and assesses the role of the Title V Maternal and Child Health Services Block Grant program in filling in gaps in coverage. It also discusses the implications of state choices on publicly-funded health coverage for pediatric health care. Report (.pdf)

  • State Responses to Budget Crisis in 2004: An Overview of Ten States – Overview and Case Studies

    Report

    In this report we examine how ten states from around the nation have responded to their budget crises in fiscal year 2004. While states vary in the depth of the budget pressures they faced, as state revenues remained depressed, all were required to make difficult choices among spending reductions, tax increases, or other revenue measures. In general, we found states with few exceptions relied on targeted revenue measures, such as cigarette and alcohol taxes, but…

  • Dual Eligibles Tables: Enrollment and Spending, by State, 2002

    Report

    This set of tables, prepared by the Urban Institue for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state by state data on Medicaid enrollment and expenditures for dual eligibles. Full Set of Tables (.pdf) Individual Tables:Implications of the Medicare drug law for full dual eligibles:Table 1: “Full” Dual Eligible Enrollment and Prescription Drug Expenditures, by State, 2002 (.pdf) Enrollment and spending data for full and partial dual eligibles:Table 2: Total…

  • Is the State Fiscal Crisis Over?  A 2004 State Budget Update – Report

    Issue Brief

    Is the State Fiscal Crisis Over? A 2004 State Budget Update - Issue Brief This paper, which updates a September 2003 analysis by the Rockefeller Institute of Government, finds that although the state fiscal situation is improving, states are by no means out of the woods yet. Issue Brief (.pdf)