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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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  • Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

    Issue Brief

    This issue brief presents national and state-level analysis of nursing homes based on the Five-Star Quality Rating System, recently updated by the Centers for Medicare and Medicaid Services (CMS) to help consumers compare nursing homes when selecting one for themselves or their family members. The issue brief finds that more than one-third (36%) of the nation’s 15,500 nursing homes certified by Medicare or Medicaid received relatively low ratings of 1 or 2 stars (out of a possible 5 stars). In 11 states, at least 40 percent of nursing homes in the state have 1- or 2-star ratings. In 23 states, however, at least half of the nursing homes have 4- or 5- star ratings. This issue brief discusses relevant policy considerations regarding nursing home quality—a serious issue in light of the vulnerability of the nursing home population and recent reports of problems arising from inadequate staffing, fire safety hazards, and substandard care.

  • Medicaid and Long-Term Services and Supports: A Primer

    Report

    This primer provides an overview of the delivery and financing of institutional and community-based long-term services and supports in the United States, highlighting Medicaid's key role in providing care, quality measurement and evaluation, and recent national reform efforts.

  • Medicaid at 50

    Report

    The Medicaid program, signed into law by President Lyndon B. Johnson on July 30, 1965, will reach its 50th anniversary this year, a historic milestone. This report reflects on Medicaid’s accomplishments and challenges and considers the issues on the horizon that will influence the course of this major health coverage and financing program moving forward.

  • Medicaid Expansion, Health Coverage, and Spending: An Update for the 21 States That Have Not Expanded Eligibility

    Issue Brief

    Ever since the Supreme Court ruled in June 2012 that states could effectively choose whether or not to accept the Affordable Care Act’s expansion of Medicaid eligibility, that choice has been one of the most prominent and often one of the most contentious issues for states. In this report, we provide new projections of the impact of Medicaid expansion on health coverage, Medicaid enrollment, and costs in states that have not expanded Medicaid.

  • How Are Hospitals Faring Under the Affordable Care Act? Early Experiences from Ascension Health

    Issue Brief

    Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on many of the nation’s hospitals through increases in the demand for care, increased patient revenues, and lower uncompensated care costs for the uninsured. This report examines the early experiences with the ACA by Ascension Health, the delivery subsidiary of the nation’s largest not-for-profit health system, Ascension. It finds that, overall, Ascension hospitals in Medicaid expansion states saw increased Medicaid discharges, increased Medicaid revenue, and decreased cost of care for the poor, while hospitals in non-expansion states saw a very small increase in Medicaid discharges, a decline in Medicaid revenue, and growth in cost of care to the poor.

  • Evolving Picture of Nine Safety-Net Hospitals: Implications of the ACA and Other Strategies

    Issue Brief

    Safety-net hospitals are an integral part of the U.S. health care landscape, providing care to some of the nation’s most medically vulnerable populations, including Medicaid enrollees and the uninsured. With the implementation of the Affordable Care Act (ACA), the U.S. health care system is rapidly changing, and safety-net hospitals need to make major adjustments to survive in the post-reform environment. This brief draws on interviews with executives at nine safety-net hospital systems and examines how their hospitals have fared since major coverage provisions of the ACA came into effect in January 2014. The brief also examines new and ongoing strategies that the hospitals are adopting in the face of a quickly changing health care environment. While acknowledging the importance of the ACA, executives at each system in the study noted that other non-ACA related factors have also shaped how their hospitals fared over the last year. The hospitals in the study were: Cook County Health and Hospital System (CCHHS); Denver Health (Denver Health); Harris Health System (Harris Health); New York City Health and Hospitals Corporation (HHC); Parkland Health and Hospital System (Parkland); Santa Clara Valley Health and Hospital System (SCVHHS); San Francisco General Hospital (SFGH); University Medical Center of Southern Nevada (UMC), and Virginia Commonwealth University Health System (VCU). These hospitals participated in two earlier related studies that examined how the systems were preparing for health care reform.

  • 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.