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What to Watch

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

The Essentials

  • 5 Facts: Medicaid and Provider Taxes

    This brief describe states’ current provider taxes and how the 2025 reconciliation law changed the federal rules governing them, including potential impacts across states.

  • Medicaid Financing: The Basics

    Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.

  • 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 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.
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.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • 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.

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  • Continued Slow Growth for Medicaid Spending in 1997

    Report

    This issue paper provides an overview of Medicaid spending in 1997. Beginning with a recap of spending and enrollment trends since the early 1990s, the authors report that Medicaid spending grew by 4.1 percent between 1996 and 1997, continuing the recent trend of slow spending growth.

  • Medicaid Enrollment in 21 States: June 1997 – June 1999

    Report

    This report, Medicaid Enrollment in 21 States: June 1997 -June 1999, prepared by Health Management Associates, includes enrollment data obtained directly from state Medicaid and CHIP programs. Findings show that across the 21 states, which represent 73% of total Medicaid enrollment, enrollment fell from 23.2 million in June 1997 to 22.

  • New Medicaid Data from 21 States Find Recent Enrollment Increases

    Report

    New data prepared for the Kaiser Commission on Medicaid and the Uninsured released April 12 find recent Medicaid enrollment increases in more than half of the 21 states surveyed. A companion report describes survey results on ways states are trying to simplify the enrollment process.

  • The Dynamics of Current Medicaid Enrollment Changes

    Report

    Insights three focus groups consisting mainly of state officials with everyday involvement in welfare and Medicaid eligibility issues. The groups were asked to identify and discuss the important forces and factors behind the overall changes in enrollment.

  • Medicaid Eligibility for the Elderly

    Report

    The purpose of this issue paper is to explain Federal Medicaid eligibility policy for the low-income elderly population and discusses Federal and State policy options to improve coverage.

  • Low-Income and Uninsured: The Challenge for Extending Coverage

    Event Date:
    Event

    Diane Rowland, executive director of the Commission, testified to the Senate Committee on Finance about the low-income uninsured. The testimony provides a comprehensive description and analysis of the population and discusses the challenges of providing them health coverage. Please note: the video is no longer available.

  • Medicaid Overview: Briefing Charts

    Report

    Complements the Medicaid primer by providing basic information and statistics about the program through a series of charts.

  • Health Coverage for Low-Income Children

    Fact Sheet

    This fact sheet, last updated in March 2001, discusses health insurance status of low-income children and reviews current programs to provide coverage to this population.

  • The Southern Institute on Children and Families: Uninsured Children in the South

    Report

    Second Report The Southern Institute on Children and Families released the first report on Uninsured Children in the South in November 1992. The report provided estimates of uninsured children by state with age and income breakouts related to Medicaid. This is the second report on Uninsured Children in the South.