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Midterm Election Update: Medicaid Changes

Major federal changes to Medicaid eligibility and financing from the 2025 reconciliation law are coming, including new work requirements that will affect millions of Medicaid enrollees. KFF’s fact sheet provides an overview of what has changed, what is still ahead, and what the public thinks about Medicaid heading into the midterms.

Medicaid State Fact Sheets 2024

Medicaid State Fact Sheets

What share of people in your state are covered by Medicaid? States varywidely in how many and which residents they cover and how much they spend. KFF’s state Medicaid fact sheets offer a snapshot of data and information on coverage, access, financing, and politics for all 50 states and DC. Get data for your state.

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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  • 5 Key Facts About Medicaid Coverage for People Living in Rural Areas

    Issue Brief

    This brief presents five key facts about Medicaid coverage among individuals living in rural areas. It draws on recent data to describe enrollment patterns, differences by state Medicaid expansion status, characteristics of the rural Medicaid population, and patterns of health care use among enrollees.

  • KFF Health Tracking Poll: Views of the One Big Beautiful Bill

    Feature

    This poll finds two-thirds of the public view the "One Big Beautiful Bill" legislation unfavorably, and its favorability erodes further when people hear about its potential health impacts. As Congress debates changes to Medicaid and the ACA as part of the bill, each program's popularity is at a record high.

  • Estimated Medicaid Enrollment Loss From the House Budget Committee Reconciliation Bill, By State

    Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States: House Reconciliation Bill

    Issue Brief

    The Congressional Budget Office’s (CBO) latest estimate shows that the One Big Beautiful Bill would reduce federal Medicaid spending by $793 and that the Medicaid provisions would increase the number of uninsured people by 7.8 million. Previous CBO estimates show that 10.3 million fewer people would be enrolled in Medicaid in 2034. Building on prior KFF analysis, this analysis allocates these estimated federal spending reductions and enrollment losses across the states.

  • KFF Health Tracking Poll: The Public’s Views of Funding Reductions to Medicaid

    Feature

    As Congress works to pass the "One Big Beautiful Bill Act," which includes significant changes to Medicaid and the ACA, the latest KFF Health Tracking Poll examines the views of groups that could be most directly impacted by the impending legislation. The poll finds most of the public is worried about the consequences of federal funding reductions to Medicaid, including rural residents, those with lower incomes, and across partisans.

  • Make American Health Care Affordable Again

    Perspective

    In this JAMA Health Forum column, Larry Levitt highlights how the Make America Healthy Again agenda aimed at chronic disease does little to address the affordability of health care and that efforts to lower federal spending on health care may worsen the problem, raising out-of-pocket costs for many people with Medicaid and Affordable Care Act coverage.

  • 5 Key Facts About Nursing Facilities and Medicaid

    Issue Brief

    The substantial Medicaid savings in the reconciliation bill that has been passed by the House could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them. Nursing facilities provide medical and personal care services for older adults and people with disabilities, and Medicaid covered 44% of long-term institutional care costs in 2023.

  • Proposed Medicaid Federal Match Penalty for States that Have Expanded Coverage for Immigrants: State-by-State Estimates

    Issue Brief

    This analysis examines the potential impacts of a provision in the House reconciliation bill that proposes reducing the federal matching rate for the Affordable Care Act (ACA) Medicaid expansion population from 90% to 80% for states that either provide health coverage or financial assistance to purchase health coverage to individuals who are not “a qualified alien.”

  • Consumer Problems with Prior Authorization: Evidence from KFF Survey

    Issue Brief

    This Data Note highlights findings from the KFF Consumer Survey on problems consumers have experienced with prior authorization requirements. Overall, those with Medicaid, those who are higher utilizers of care, and those who seek certain types of care such as care for a mental health condition or diabetes encountered more problems with prior authorization over the past year.