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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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  • Money Follows the Person: A 2015 State Survey of Transitions, Services, and Costs

    Report

    The Money Follows the Person (MFP) demonstration provides enhanced federal matching funds, allowing states to better support Medicaid long-term services and supports beneficiaries in transitioning from institutions back to the community. This report highlights 2015 MFP enrollment and spending trends and services and supports offered across state MFP demonstrations.

  • Women’s Health Issues Journal: Medicaid and Women’s Health Coverage Two Years into the Affordable Care Act

    Issue Brief

    As Medicaid marks its 50th year, the program has unquestionably become the mainstay of health coverage for low-income women in the nation. Since its inception, its role for women has continued to evolve and expand, but the passage of the Affordable Care Act (ACA) swung open the doors for Medicaid to serve even more low-income women who lack access to private or employer-based insurance. This is because the ACA enabled states to finally eliminate Medicaid's historical “categorical” requirements, which had essentially shut out women and men without dependent children.

  • Medicaid Enrollment & Spending Growth: FY 2015 & 2016

    Issue Brief

    This report provides an overview of Medicaid financing and Medicaid spending and enrollment growth with a focus on state fiscal years 2015 and 2016 (FY 2015 and FY 2016.) Findings are based on interviews and data provided by state Medicaid directors as part of the 15th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) survey and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth and also look at expansion versus non-expansion states.

  • Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2015 and 2016

    Issue Brief

    This report provides an in-depth examination of Medicaid program changes in the larger context of state budgets in three states: Alaska, California, and Tennessee. These case studies build on findings from the 15th 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).

  • Medicaid Reforms to Expand Coverage, Control Costs and Improve Care: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2015 and 2016

    Report

    This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 15th 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), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2015 and those planned for implementation in FY 2016 based on information provided by the nation’s state Medicaid Directors. Key areas covered include changes in eligibility and enrollment, delivery and payment system reforms, provider payment rates, and covered benefits (including prescription drug policies).

  • The Wisconsin Health Care Landscape

    Fact Sheet

    Wisconsin has long been a leader among states in expanding coverage to its low-income residents since even before the major coverage provisions of the Affordable Care Act (ACA) took effect on January 1, 2014.

  • The Great Medicaid Divide

    From Drew Altman

    In his Axios column, Drew Altman examines how the core views Republicans have about Medicaid differ from those of Democrats and Independents, and how those views drive the policy changes they are proposing for the program.

  • Medicaid’s Role in Nursing Home Care

    Other

    This infographic highlights Medicaid’s role for nursing home care. It includes information about the nation's growing long term care need and the role Medicaid plays as the primary payer for nursing home care. It also discusses the potential impact of proposals to limit federal Medicaid financing.

  • No Easy Choices: 5 Options to Respond to Per Capita Caps

    Issue Brief

    Under a per capita cap, per enrollee spending would be capped, but the total amount of federal dollars to states could vary with enrollment changes and states would not be able to impose enrollment caps. Faced with restrictions in federal financing, states would have to make hard choices. This brief outlines the key measures states could use to manage their budgets and the associated challenges under a per capita cap: raise taxes or make other cuts, reduce benefits, limit coverage of high cost enrollees, reduce rates or implement delivery system reforms, and promote personal responsibility. Each option has challenges that are identified in the brief.