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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

The Impact of H.R. 1 on Two Medicaid Eligibility Rules

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?

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.

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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  • Eliminating the Medicaid Expansion Federal Match Rate: State-by-State Estimates

    Issue Brief

    This analysis examines the potential impacts on states and Medicaid enrollees of eliminating the 90% federal match rate for the Affordable Care Act (ACA) expansion. Eliminating the federal match rate for adults in the Medicaid expansion could reduce Medicaid spending by nearly one-fifth ($1.9 trillion) over a 10-year period and up to nearly a quarter of all Medicaid enrollees (20 million people) could lose coverage.

  • 5 Key Facts About Medicaid Coverage for People with Disabilities

    Issue Brief

    This brief considers options under consideration to cut Medicaid spending by $2.3 trillion over ten years and their potential impact on people with disabilities. Policy changes such as per capita caps, reduced federal funding for the ACA expansion, and Medicaid work requirements could require states to limit coverage, reduce benefits, or cut provider payments. Given their higher health care costs and reliance on Medicaid for essential services, people with disabilities could be especially affected.

  • 5 Key Facts About Medicaid Eligibility for Seniors and People with Disabilities

    Issue Brief

    Nearly 1 in 4 Medicaid enrollees are eligible for the program because they are ages 65 and older or have a disability, and they have higher per-enrollee costs than other enrollees. Proposals to limit federal spending on Medicaid may create incentives for states to drop or reduce their eligibility or coverage for seniors and people with disabilities in response to fewer federal revenues. Considering the proposed reductions in Medicaid spending, this issue brief describes Medicaid eligibility pathways, enrollment, and spending among people eligible through the age and disability-related pathways.

  • Medicaid 1115 Waiver Watch: Round-up of Key Themes at the End of the Biden Administration

    Issue Brief

    Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” Waivers generally reflect priorities identified by states as well as changing priorities from one presidential administration to another. The Biden administration encouraged states to propose waivers that expand coverage, reduce health disparities, advance whole-person care, and improve access to behavioral health care. Looking ahead, the new Trump administration’s waiver priorities will likely differ significantly from those of the Biden administration. However, it is unclear how the Trump administration will treat certain waivers promoted and approved by the Biden administration.

  • Could Trump Walk Away from Unpopular Health Proposals?

    From Drew Altman

    In a new column, KFF President and CEO Drew Altman discusses what President Trump’s decision to pull back the broad freeze in federal grant funding might portend for his response to future policies in health that prove controversial or unpopular.

  • Medicaid Financing: The Basics

    Issue Brief

    Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the 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.

  • Medicaid Section 1115 Waivers: The Basics

    Issue Brief

    Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute. Nearly all states have at least one active Section 1115 waiver and some states have multiple 1115 waivers. This brief explains what Section 1115 waivers are and how they are used, summarizes key waiver requirements, and outlines the application and approval process.