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Number of States Affected by Key Provisions of 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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  • Governors’ Proposed Budgets for FY 2019: Focus on Medicaid and Other Health Priorities

    Issue Brief

    This issue brief provides Medicaid highlights from governors’ proposed budgets for state fiscal year (FY) 2019 (July 1, 2018 through June 30, 2019 in most states). Proposed budgets reflect the priorities of the governor and are often blueprints for the legislature to consider. In total, we reviewed 39 proposed state budgets and text from 46 state of the state speeches. This review revealed that while state revenue collections improved in 2017 compared to 2016, considerable…

  • Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016

    Report

    This report provides information on recent trends in nursing facilities in the United States, drawing on data from the federal On-line Survey, Certification, and Reporting system (OSCAR) and more recent Certification and Survey Provider Enhanced Reports (CASPER). We use these databases to provide information on nursing facility characteristics, resident characteristics, facility staffing, and deficiencies by state from 2009 through 2015. This data enables policymakers and the public to monitor and understand recent changes in nursing…

  • How Might Older Nonelderly Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waivers?

    Issue Brief

    Most of the states with approved or pending Section 1115 waivers that condition Medicaid eligibility on work would apply those requirements to all or most nonelderly adults (ages 19-64) who are not receiving Supplemental Security Income (SSI) cash assistance, including older nonelderly adults (ages 50-64). Older nonelderly adults may be limited in their ability to satisfy a work requirement due to barriers resulting from age and/or disability. Previous analysis shows that many nonelderly Medicaid adults…

  • Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey

    Report

    This 16th annual 50-state survey provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2018. It takes stock of how the programs have evolved as the fifth year of implementation of the Affordable Care Act (ACA) begins, discusses policy changes made during 2017, and looks ahead to issues that may affect state policies moving forward. It is based on a survey of state…

  • KFF Briefing Examines Progress and Remaining Challenges for the Health Care Systems in Puerto Rico and U.S. Virgin Islands Six Months After Hurricanes Irma and Maria

    News Release

    Six months after hurricanes Irma and Maria made landfall across Puerto Rico and the U.S. Virgin Islands, local officials described progress but also a long road to full recovery of the U.S. territories’ health care systems, economies and infrastructure during a public briefing Monday at the Kaiser Family Foundation’s Washington D.C. offices. An archived webcast of the 90-minute briefing on the status of the recovery on the islands, with a focus on their health care systems,…

  • Both Expansion and Non-Expansion States Have Implemented Modernized Medicaid Systems to Streamline Enrollment under the ACA

    News Release

    Under the Affordable Care Act, Medicaid expansion and non-expansion states alike have implemented streamlined Medicaid enrollment systems that facilitate real-time eligibility determinations and automated renewals, according to a new 50-state survey from the Kaiser Family Foundation. Before the ACA, individuals could not apply for Medicaid by phone or online in many states. They typically had to provide paper documentation like pay stubs and wait weeks for an eligibility determination – and do it all over…

  • Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Event)

    Event Date:
    Event

    Six months after Hurricanes Irma and Maria battered Puerto Rico and the U.S. Virgin Islands, the U.S. territories continue to struggle with crippled infrastructure, faltering economies and an exodus of their populations to the continental U.S.  On Monday, March 19, 2018, the Kaiser Family Foundation held a public briefing to examine the status of the recovery on the islands, with a focus on how their health care systems are doing and the likely impact of…

  • Health Centers in Puerto Rico: Operational Status after Hurricane Maria

    Fact Sheet

    In the aftermath of Hurricane Maria, Puerto Rico's health centers, a critical part of the island's health care system are working to rebuild; however, recovery remains slow and plagued by many challenges. This interactive map provides a snapshot of the operational status of the 93 health center sites in Puerto Rico.