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2025 Reconciliation Law

How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?

This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10 million in 2034. That number would rise to over 14 million if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.

ANALYSIS

Allocating Federal Medicaid Spending Reductions Across States

Policy Tracker

Medicaid Provisions in the 2025 Budget Reconciliation Law

ANALYSIS

How Might Federal Medicaid Cuts Affect Rural Areas?

From Drew Altman

Can Democrats Make Medicaid and ACA Cuts Their Winning Political Issue?

The Essentials

  • 5 Facts: Medicaid and Provider Taxes

    As Congress weighs potential cuts in federal Medicaid spending, one option under consideration is to limit the use of state taxes on providers. This brief describe states’ current provider taxes and the federal rules governing them.

  • 5 Facts: Medicaid Work Requirements

    This brief highlights five key facts about Medicaid work requirements, including the share of Medicaid enrollees who currently work, what research shows about the impact of work requirements, and the administrative burdens associated with implementing them.

  • Implementing National Work Requirements

    Federal Medicaid work requirements raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.

  • Medicaid Financing: The Basics

    Medicaid represents $1 out of $6 spent on health care in the U.S. and is the major source of financing for state health coverage and long-term services and supports for low-income residents.
     

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.

  • Adults with Mental Illness

    Options under consideration in Congress to significantly reduce Medicaid spending could have major implications for adults who live with mental illness.

  • 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.

key facts about medicaid

  • 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 Family Planning

    As the largest public payer for family planning services in the US, changes to Medicaid could have a large impact on access to contraception and other family planning care for low-income individuals.

  • 5 Facts: Medicaid for People 50 and Older

    The budget reconciliation bill that includes significant changes to the Medicaid program. Many of the reductions in coverage will be among the 22 million Medicaid enrollees ages 50 and older.

  • 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.

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  • Putting Medicaid in the Larger Budget Context: An In-Depth Look at Four States in FY 2016 and FY 2017

    Issue Brief

    This report provides an in-depth examination of Medicaid program changes in the larger context of state budgets in four states: Maryland, Montana, New York, and Oklahoma. These case studies build on findings from the 16th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) and Health Management Associates (HMA).

  • Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017

    Feature

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings in this report are drawn from the 16th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2016 and those implemented or planned for FY 2017 based on information provided by the nation’s state Medicaid directors. Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, and covered benefits (including prescription drug policies).

  • 50-State Survey Finds Slower Growth in Total Medicaid Spending Nationally in FY 2016 and Projected for FY 2017 as Earlier Increases from the Affordable Care Act’s Coverage Expansions Taper Off

    News Release

    After record increases in fiscal year 2015, growth in Medicaid enrollment and total Medicaid spending nationally slowed substantially in FY 2016 and are projected to continue to slow in FY 2017 as the initial surge of enrollment under the Affordable Care Act’s coverage expansions tapered off, according to the 16th annual 50-state Medicaid Budget Survey by the…

  • Medicaid Enrollment & Spending Growth: FY 2016 & 2017

    Issue Brief

    This report provides an overview of Medicaid enrollment and spending growth with a focus on the most recent state fiscal year, FY 2016, and current state fiscal year, FY 2017. Findings are based on interviews and data provided by state Medicaid directors as part of the 16th annual Medicaid budget survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth and also look at expansion versus non-expansion states.

  • Spending and Utilization of EpiPen within Medicaid

    Issue Brief

    Medicaid is also a major provider of EpiPen and has been impacted by its increasing price. In this Data Note, we examine utilization, spending before rebates, and spending per prescription of EpiPen and other epinephrine auto-injectors before rebates in the Medicaid program.

  • Data Note: Effect of State Decisions on State Risk Scores

    Issue Brief

    To gauge whether individual market risk pools are healthier in states that have expanded Medicaid and did not allow transitional plans, this data note compares average state risk scores using data from the Centers for Medicare & Medicaid Services Summary Report on Risk Adjustment for the 2015 benefit year. The analysis finds that states that expanded Medicaid and did not allow transitional plans had lower average risk scores, suggesting the risk pools in those state’s markets are healthier than in non-expansion states and in states that allowed transitional plans.

  • Snapshot of Where Hillary Clinton and Donald Trump Stand on Seven Health Care Issues

    Issue Brief

    Where do the 2016 Presidential candidates, Hillary Clinton and Donald Trump, stand on key health care issues? This snapshot outlines the candidates' positions and policy statements on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, women's reproductive health, and Zika.

  • Puerto Rico: Medicaid, Fiscal Issues and the Zika Challenge

    Fact Sheet

    Roughly one in two Puerto Ricans (49%) are enrolled in the island’s Medicaid program. This fact sheet provides an overview of the Medicaid program in Puerto Rico and emerging fiscal issues facing its health care system as Zika cases on the island continue to mount.

  • 8 Questions & Answers about Puerto Rico

    Fact Sheet

    These slides provide a quick snapshot of Puerto Rico’s population, as well as current and upcoming issues that are impacting the island’s health care system.