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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.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

Tracking Medicaid Work Requirements:
Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

understanding medicaid

5 Facts: Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

5 Facts: Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

5 Facts: Medicaid and Immigrants

Confusion persists about immigrants’ eligibility for federal programs. This brief helps readers understand how current Medicaid policy affects immigrants as well as the potential impacts of policy changes under the Trump administration.

5 Facts: Medicaid and Rural Areas

Approximately 66 million people live in rural areas – about 20% of the U.S. population. Nearly 1 in 4 of them have Medicaid, a higher share than in urban areas (24% vs 21%).

5 Facts: Nursing Facilities

The substantial Medicaid savings in the reconciliation bill that has been passed by the House could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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.

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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  • The Texas Health Care Landscape

    Report

    This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.

  • The Texas Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.

  • California and Texas: Section 1115 Medicaid Demonstration Waivers Compared

    Fact Sheet

    This fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010.

  • Inside Deficit Reduction: What It Means For Medicaid

    Event Date:
    Event

    This briefing, co-sponsored by the Alliance for Health Reform, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation, featured panelists discussing which deficit-reduction proposals affecting Medicaid might receive serious consideration by the congressional "super committee," as well as what kind of impact such changes would have on Medicaid enrollees, providers and…

  • Carmen, Crystal, and Nelly Rosado

    Other Post

    When Carmen Rosado got divorced a few years ago, she and her two teen daughters, Crystal and Nelly, lost their private health insurance. Carmen took a new job working nights, but it offered no health coverage and, without Medicaid, the family would have been uninsured.

  • Claire Smith

    Other Post

    Claire Smith, now 5 years old, was born with a rare genetic syndrome whose symptoms include multiple, severe physical, developmental, and intellectual disabilities. Claire’s family has private health insurance, but because of its bureaucratic barriers, her parents have had to struggle to obtain the care Claire needs.

  • Edward Henry

    Other Post

    Edward Henry, age 64, lives independently now, following three years in nursing homes after he lost both legs to an infection. Edward’s goal was always to live again on his own, and he was able to make this transition through Georgia Medicaid’s “Money Follows the Person” (MFP) program.

  • Brenda Christiansen

    Other Post

    Brenda Christiansen, age 52, was diagnosed with breast cancer about a year ago. When she first noticed a worrisome lump, she was in the three-month waiting period for the health insurance offered through the nursing job she had recently taken. Within days of qualifying for this coverage, she was laid off.

  • Michelle Foster

    Other Post

    Michelle Foster and her four-month-old baby, Anthwonnia, have both benefited from Medicaid. With Medicaid, Michelle received all her prenatal care on time, and, when she developed gestational diabetes, she was able to get the specialist care that she needed as well.