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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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  • Faces of Medicaid

    Video

    The "Faces of Medicaid" video series highlights the range of experience and diverse roles that Medicaid plays in the lives of Americans across the U.S. These stories of individuals on Medicaid go beyond statistics and provide insight into the range of personal experiences with the program.

  • New Analysis Shows States with Medicaid Expansion Experienced Declines in Uninsured Hospital Discharges

    Issue Brief

    Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on hospital payer mix across the country. Similar to other reports recently released, new data examining hospital discharges in 16 states with data through the second quarter in 2014 show increases in Medicaid and declines in uninsured or self-pay discharges in states that implemented the Medicaid expansion. These trends hold true for all hospital discharges as well as for specific…

  • Economic and Fiscal Trends in Expansion and Non-Expansion States: What We Know Leading Up to 2014

    Issue Brief

    This brief was prepared with the Rockefeller Institute of Government, the public policy research arm of the State University of New York. It is designed to provide some insight into the underlying economic and fiscal conditions in expansion and non-expansion states leading up to 2014 by looking at the typical (i.e. median) state for each group. This analysis will provide a framework against which to measure the impact of expansion decisions going forward. The sections…

  • Long-Term Care in the United States: A Timeline

    Other Post

    Long-term care (LTC) in the United States has evolved over the course of the last century to better serve the needs of seniors and person with disabilities. This long-term care timeline outlines the major milestones in LTC from the nursing home era, which created an institutional bias in LTC, to the era of home and community based services (HCBS) and integration, and into the era of health reform and beyond.

  • The California Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of population health, health coverage, and the health care delivery system in California in the era of health reform.

  • The ‘Private Option’ Medicaid Expansion in Arkansas Has Helped Reduce the Uninsured Rate and Uncompensated Care Costs While Boosting the State’s ACA Marketplace

    News Release

    A new issue brief from the Kaiser Family Foundation finds that Arkansas’ “private option” Medicaid expansion has helped reduce the number of uninsured and bring down uncompensated care costs while strengthening the state’s ACA marketplace. A Look at the Private Option in Arkansas draws upon early data as well as interviews conducted in spring 2015 with state officials, providers, insurance carriers, and consumer advocates to provide an initial look how implementation of the private option…

  • A Look at the Private Option in Arkansas

    Issue Brief

    Based on stakeholder interviews and early data on coverage, reduced uncompensated care costs, and other topics, this issue brief provides an initial look at implementation of Arkansas' Section 1115 Medicaid expansion demonstration waiver to require most adults newly eligible for Medicaid through the Affordable Care Act's Medicaid expansion to enroll in Marketplace plans.

  • Dual Eligible Demonstrations: The Beneficiary Perspective

    Issue Brief

    This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.

  • Racial and Ethnic Disparities in Access to and Utilization of Care among Insured Adults

    Issue Brief

    This analysis based on data from the 2014 Kaiser Survey of Low-Income Americans examines differences in access to and utilization of care for Black and Hispanic adults compared to White adults among those who are uninsured, enrolled in Medicaid, and privately insured. The findings suggest that gains in health coverage under the ACA will lead to improvements in access to care and utilization for White, Black, and Hispanic adults. They also highlight the importance of…