A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes
This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.
Medicaid
Medicaid Budget Survey
State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes
As states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
Work Requirements
Challenges Implementing Work Requirements
To better understand how states are preparing for Medicaid work requirements, states were asked to discuss anticipated challenges to implementing work requirements by the end of 2026, including related system changes and data matching.
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.
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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