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Number of States Affected by Key Medicaid Provisions in the 2025 Reconciliation Law

Which States Will Be Affected by Key Medicaid Provisions in the 2025 Reconciliation Law?

The 2025 reconciliation law makes sweeping changes to Medicaid that will affect every state through key eligibility and financing changes, including new work requirements, immigrant eligibility restrictions, and changes to provider taxes and state directed payments. This issue brief explains which states will be affected by each of these key provisions.

Medicaid work requirements

Nebraska Renewal Outcomes Among Individuals Subject to Medicaid Work Requirements

Early Medicaid Work Requirement Insights From Nebraska

This brief describes the verification process for Medicaid work requirements in Nebraska and examines early data on outcomes for individuals subject to work requirements. Among Medicaid enrollees renewing coverage under Nebraska's work requirements, 93% met the requirements or qualified for an exemption —while 7% lost coverage.

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. The Congressional Budget Office estimates that the 2025 reconciliation law will increase the number of people who are uninsured in 2034 by 10 million. Coverage losses from Medicaid work requirements account for over half, or 5.3 million, of the increase in the number of uninsured.

understanding medicaid

Medicaid Financing: The Basics

Medicaid represents $1 out of every $5 spent on health care in the U.S. This brief examines key questions about Medicaid financing and how it works.

Medicaid and Provider Taxes

This brief explores how rules governing provider taxes are changing because of the 2025 reconciliation law and the regulations implementing that law, and summarizes which changes may affect each state.

5 Key Facts About Medicaid and Hospitals

This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid and how Medicaid expansion has impacted hospital finances.

Medicaid home Care

Medicaid Home Care/HCBS Survey

Since 2001, KFF has administered regular surveys of states about their Medicaid home- and community-based services (HCBS) programs. The survey is sent to officials administering Medicaid HCBS programs in all 50 states and the District of Columbia.

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  • Massachusetts Health Care Reform: Six Years Later

    Issue Brief

    In 2006, then-Gov. Mitt Romney signed Massachusetts' comprehensive health reform designed to provide near-universal health insurance coverage for state residents. Building on a long history of health reform efforts, the state embarked on an ambitious plan to promote shared individual, employer, and government responsibility. This brief examines Massachusetts' experience with coverage and access to care over the last six years, as well as the state's ongoing efforts to deal with persistent high health-care costs. The…

  • Eliminating Adult Dental Coverage in Medicaid: An Analysis of the Massachusetts Experience

    Report

    This report examines the impact of Massachusetts eliminating coverage of most dental services for adults in its Medicaid program, MassHealth. The report findings include: In FY2004, 100,000 fewer MassHealth adult enrollees received dental services reimbursed by MassHealth than in FY2001, the year prior to the reductions; The number of private dentists actively treating MassHealth patients declined after the reductions, and dental directors at community health centers (CHCs) indicated that they did not have the capacity…

  • Key Facts – Louisiana and the U.S.

    Fact Sheet

    Key Facts - Louisiana and the U.S. A fact sheet on the demographics and health coverage of Louisiana's population Fact Sheet (.pdf)

  • Deficit Reduction Act of 2005: Implications for Medicaid

    Issue Brief

    This issue brief summarizes the Medicaid provisions of the budget reconciliation law signed in February 2006 and discusses the implications of the proposed changes. The changes would net reductions of $4.8 billion over the next five years and $26.1 billion over the next ten years from current Medicaid spending. Issue Brief (.pdf)

  • 2004 State and National Medicaid Spending Data (CMS-64)

    Report

    This set of tables, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state-by-state information on Medicaid spending by services using data from the Centers on Medicaid and Medicare Services (CMS) Form 64 for Federal Fiscal Year (FFY) 2004. CMS-64 data provide a somewhat different measure of spending than does the Medicaid Statistical Information System (MSIS). Please refer to the "Overview of Differences" document below for…

  • New Publications on Immigrant Health Care and Linguistic Access

    Fact Sheet

    In 2000, there were over 32 million foreign-born residents in the U.S. Immigrants often face barriers to health coverage and health services. The disparities confronting immigrants can be similar to those faced by low-income working families generally, but immigrants also face other barriers, including linguistic issues and eligibility changes that have limited their ability to qualify for Medicaid. These new or updated publications address issues related to how race, immigration status, and language affect insurance…

  • Survey of People with Disabilities

    Poll Finding

    People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. This chartpack contains the briefing materials from the event held to release the survey. Chart Pack (.pdf)

  • Beyond Cash and Counseling: The Second Generation of Individual Budget-Based Community Long-Term Care Programs for the Elderly

    Report

    States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. Beginning in January 2007, a new provision in the Deficit Reduction Act of 2005 (DRA) allows states to offer an individual budget option for an expanded range of home- and community-based services in their Medicaid state plans…

  • Medicaid Prescription Drug Spending and Use

    Issue Brief

    This issue paper provides the latest data and trend analysis on Medicaid prescription drug spending and utilization. In 2002, Medicaid programs spent $30 billion for prescribed drugs. Issue Paper (.pdf)

  • Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Report

    This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and fraud and abuse. Report (.pdf)