Medicaid

What to Watch

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

The Essentials
  • 5 Facts: Medicaid and Provider Taxes

    This brief describe states’ current provider taxes and how the 2025 reconciliation law changed the federal rules governing them, including potential impacts across states.
  • Medicaid Financing: The Basics

    Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.
  • 5 Facts: Immigrants and Medicaid

    This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.
  • 5 Facts: Medicaid and Hospitals

    This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.
  • 5 Facts: Medicaid and Nursing Facilities

    The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.
Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Key Questions About Medicaid Block Grants

    News Release

    As policymakers in Washington discuss Affordable Care Act repeal and a possible block grant for Medicaid, a new issue brief from the Kaiser Family Foundation lays out key questions to consider in restructuring federal financing of the nation’s health insurance program for low-income Americans.

  • 5 Key Questions: Medicaid Block Grants & Per Capita Caps

    Issue Brief

    Medicaid covers more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities in the United States. The program represents $1 out of every $6 spent on health care in the US and is the major source of financing for states to provide coverage for the health and long-term needs of low-income residents. President Trump and other GOP leaders have called for fundamental changes in the structure and financing of Medicaid. This brief outlines five key questions to consider as the debate moves forward as well as some potential implications of these changes for states, beneficiaries and providers.

  • Current Flexibility in Medicaid: An Overview of Federal Standards and State Options

    Issue Brief

    The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would have significant implications. To help inform discussion around increased flexibility, this brief provides an overview of current federal standards and state options in Medicaid and how states have responded to these options in four key areas: eligibility, benefits, premiums and cost sharing, and provider payments and delivery systems.

  • Linking Medicaid and Supportive Housing: Opportunities and On-the-Ground Examples

    Issue Brief

    There is evidence that supportive housing can contribute to improved outcomes for people experiencing homelessness or at risk of homelessness. It can also advance community integration of seniors and people with disabilities. Medicaid does not pay for room and board, but it can pay for many housing-related services for Medicaid beneficiaries. This issue brief discusses how Medicaid can support integrated strategies and profiles three initiatives that illustrate different approaches to linking Medicaid and supportive housing.

  • 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.

  • Community Health Centers: Recent Growth and the Role of the ACA

    Issue Brief

    This brief draws on federal data and our 2016 survey of health centers to provide a 2015 profile of health centers, analyze recent changes in patient coverage and service capacity, and compare health centers in Medicaid expansion and non-expansion states. It also considers the implications of a repeal of the ACA for health centers and the low-income communities they serve.

  • Median Medicaid/CHIP Income Eligibility Levels by Group

    Feature

    median-medicaid-chip-income-eligibility-thresholds-jan-2017 Download Source Based on  results from a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, 2017.