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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?

Work Requirements

How Will States Implement Medicaid Work Requirements?

Event Date:

Four experts, including two state Medicaid directors, will join Health Wonk Shop moderator Larry Levitt in an hour-long discussion of how states will go about implementing new Medicaid work requirements.

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.

The Essentials

  • 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.

  • 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: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 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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  • Briefing on the ACA in CA: Year One & Beyond

    Event Date:
    Event

    Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation examined ACA implementation in California (CA) at a Sacramento, Calif. briefing and panel discussion on May 28. A state official, experts and advocates discussed issues and challenges related to implementation of the law, and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state marketplace or the Medi-Cal expansion.

  • Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Report

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report, based on the 2014 Kaiser Survey of Low-Income Americans aims to fill this gap by comparing the newly insured, previously insured and remaining uninsured across several of these important dimensions.

  • Access to Care for the Insured and Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Issue Brief

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report, based on the 2014 Kaiser Survey of Low-Income Americans aims to fill this gap by comparing the newly insured, previously insured and remaining uninsured across several of these important dimensions.

  • Medicaid Balancing Incentive Program: A Survey of Participating States

    Report

    The Balancing Incentive Program provides enhanced federal matching funds, allowing states to advance their efforts to rebalance Medicaid long-term services and supports (LTSS) spending and expand access to home and community-based services as an alternative to institutional care. This report highlights participating states' efforts to implement the program's three structural requirements and use the enhanced federal funds in support of other Medicaid LTSS rebalancing efforts.

  • Behavioral Health Parity and Medicaid

    Issue Brief

    This issue brief explains how behavioral health parity applies in the Medicaid program, including the major provisions of the Centers for Medicare and Medicaid Services’ (CMS) April 10, 2015 proposed regulations, and identifies key policy issues at the intersection of behavioral health parity and Medicaid.

  • Medicaid 101: What You Need To Know

    Event Date:
    Event

    With some states grappling over whether to expand Medicaid, and Congress facing big decisions about the future of the Children's Health Insurance Program (CHIP), this briefing reviewed the basics about both programs, and discuss current issues. Co-hosted by the Kaiser Family Foundation and the Alliance for Health Reform, KFF's Diane Rowland and Ed Howard of the Alliance moderated the discussion.

  • Takeaways From Alaska’s Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses the implications of the governor of Alaska’s decision to move ahead unilaterally with Medicaid expansion.

  • Proposed Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    This issue brief summarizes major provisions of the Notice of Proposed Rulemaking (NPRM) to modernize and strengthen federal Medicaid managed care regulations, which serves as an informational guide to key proposed new federal expectations and requirements of states and managed care arrangements, and federal oversight interests moving forward.