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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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  • Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation

    Issue Brief

    Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)

  • The Implications of a Loss in Public Health Coverage

    Event Date:
    Event

    A new Health Affairs article and a policy brief examine the implications of cuts to public coverage programs like Medicaid and SCHIP. The Health Affairs article finds that Medicaid and SCHIP cuts would increase emergency department visits by the uninsured, suggesting that cost containment actions on public coverage programs would shift costs to hospital uncompensated care. The policy brief examines the share of current enrollees in public programs who would have other coverage options if…

  • Health Centers Reauthorization: An Overview of Achievements and Challenges

    Report

    This report reviews the role of community health centers in the nation's health care safety net. Today, over 1,000 federally funded and “look-alike” health centers serve 14.3 million people, three-quarters of whom are uninsured or covered by Medicaid. As health centers look toward legislative reauthorization in 2006, they face several policy challenges reviewed in this report, including an increase in the uninsured populations, potential decreases in Medicaid revenue, and a need to increase health centers'…

  • Key Issues and Opportunities: Implementing the New Medicaid Integrity Program

    Report

    The Deficit Reduction Act of 2005 created a new Medicaid Integrity Program to increase the government's capacity to prevent, detect and address fraud and abuse in the Medicaid program. The new initiative represents the most significant single, dedicated investment the federal government has made in ensuring the integrity of the Medicaid program and offers an opportunity to ensure the efficient administration of the program and promote sound stewardship of state and federal resources. The Kaiser…

  • KYHealth Choices Medicaid Reform: Key Program Changes and Questions

    Fact Sheet

    This fact sheet summarizes the key changes Kentucky has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. Kentucky uses new options related to benefits, cost sharing and long-term care. Fact Sheet (.pdf)

  • Health Coverage for Low-Income Americans:  An Evidence-Based Approach to Public Policy

    Report

    Health Coverage for Low-Income Americans: An Evidence-Based Approach to Public Policy This report offers an evidence-based framework for developing public policy approaches to covering low-income Americans. The first part of the report is devoted to the question: What is the role for publicly sponsored health insurance? The second part turns to seven central issues in structuring a publicly sponsored health insurance program for the low-income population. The report outlines each of these issues, provides a…