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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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  • Community Health Centers: A 2013 Profile and Prospects as ACA Implementation Proceeds

    Issue Brief

    Community health centers are an integral part of the health care safety-net, providing access to care for nearly 22 million people in underserved communities. The ACA established trust fund for health center growth, and with increased patient revenues attributable to expanded coverage, health centers’ grant funding to support care of the uninsured can go further. This brief provides a 2013 data profile of health centers; highlights pre-ACA differences between health centers in Medicaid expansion and non-expansion states; and considers financial challenges facing health centers and the implications of state Medicaid decisions, the outcome of King v. Burwell, and the approaching sunset of the special trust fund for health centers’ capacity to ensure access to care for the communities they serve.

  • The Effects of the Medicaid Expansion on State Budgets: An Early Look in Select States

    Issue Brief

    This brief examines the early state budget effects of the ACA Medicaid expansion in three states: Connecticut, New Mexico, and Washington State. States were asked about savings and costs in Medicaid, behavioral health, corrections, uncompensated care spending, etc. as well as revenues. Findings from a study looking at Kentucky are also included.

  • Medicaid Moving Forward

    Issue Brief

    Medicaid is the nation’s main public health insurance program for people with low incomes, and it is the single largest source of health coverage in the U.S., covering nearly 70 million Americans. Medicaid also finances 16% of total personal health spending in the nation. States design and administer their own Medicaid programs within federal requirements, and states and the federal government finance the program jointly. As a major payer, Medicaid is a core source of financing for safety-net hospitals and health centers that serve low-income communities, including many of the uninsured. It is also the main source of coverage and financing for both nursing home and community-based long-term care.

  • ACA 101: What You Need To Know

    Event Date:
    Event

    On Friday, March 6, 2014, the Kaiser Family Foundation and the Alliance for Health Reform hosted an ACA 101 briefing on the Affordable Care Act. The briefing took place just as the second marketplace enrollment period ended, and the Supreme Court heard oral arguments in a case challenging the ACA's subsidies (King v Burwell).

  • Are Uninsured Adults Who Could Gain Medicaid Coverage Working?

    Fact Sheet

    As additional states consider whether to implement the ACA Medicaid expansion, some have raised pursuing waiver authority to tie Medicaid eligibility for adults under the expansion to work requirements. This fact sheet profiles uninsured adults who could gain Medicaid coverage under the ACA by their relationship to the workforce and job-based coverage.

  • An Overview of Actions Taken by State Lawmakers Regarding the Medicaid Expansion

    Fact Sheet

    The ACA Medicaid expansion has garnered different responses from statelawmakers - Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.

  • Trends in Medicaid Spending Leading up to ACA Implementation

    Issue Brief

    This paper presents data on Medicaid spending during the years leading up to the implementation of the Affordable Care Act (ACA). It uses administrative data to first examine overall spending trends and trends by service type. We then draw on additional data to analyze per enrollee spending growth during this period, both by service type and by eligibility group, to understand what drove Medicaid spending.

  • Safety-Net Emergency Departments: A Look at Current Experiences and Challenges

    Issue Brief

    Safety-net hospital emergency departments (EDs) are an important part of our health care system, especially, but not only, for the uninsured and others with low income. With multiple major changes unfolding in our system today, including the development of new models of health care delivery, payment reforms, expanded insurance coverage, and increasing demand for primary care access, safety-net EDs are a sort of crucible in which these shifts and transitions can be seen playing out. To understand more about their current experiences and challenges as the Affordable Care Act (ACA) begins to takes hold, we conducted interviews with ED directors in a convenience sample of 15 safety-net hospitals around the country in June and July 2014.

  • Medicare Spending Peaks at Age 96  

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care. All previous columns by Drew Altman are available online.