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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

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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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  • Health Care After the Supreme Court Decision: What’s Next?

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation discuss the recent Supreme Court ruling on the constitutionality of the health reform law. Panelists explore such questions as: What does the court's ruling mean for those without health insurance? Will states that choose to participate in the Medicaid expansion be ready to cover nearly all non-disabled adults under age 65 with household incomes at or below 133 percent of the federal poverty level as…

  • Medicaid and SCHIP Eligibility for Immigrants

    Fact Sheet

    Immigrants in the U.S. face increasing challenges securing health care coverage. They have less access to employer-sponsored insurance than native citizens and face tighter restrictions on their eligibility for Medicaid and SCHIP, the nation’s major public health coverage programs for low-income children and families. This fact sheet provides an overview of the current rules on immigrants' eligibility for Medicaid and the State Children's Health Insurance Program. Fact Sheet (.pdf)

  • State Medicaid Actions Related to the Passage of the Deficit Reduction Act: A Background Briefing for Reporters on the Latest Developments

    Fact Sheet

    The Deficit Reduction Act (DRA) of 2005 was signed into law in February 2006 with several significant changes to the Medicaid program affecting both health and long-term care coverage as well as new citizenship requirements. States were granted greater flexibility in charging copayments and premiums and modifying the benefit package for certain Medicaid beneficiaries. Changes of this type previously required a waiver and now can be done by amending the state plan. The first two…

  • Observations on the Initial Implementation of the Medicare Prescription Drug Program:  Perspectives of State Medicaid Directors Through a Focus Group Discussion

    Report

    Observations on the Initial Implementation of the Medicare Prescription Drug Program: Perspectives of State Medicaid Directors Through a Focus Group Discussion Medicaid directors express the need to continue to focus on the interaction between Medicaid and the Medicare prescription drug benefit and to address the key system and coordination issues that remain, particularly with the potential disruptions that could occur in January 2007 when new Medicare drug plan contracts and recalculated benchmarks for the low-income…

  • National Council of Jewish Women features article on “Diagnosing Women’s Health Care”

    Other Post

    National Council of Jewish Women features article on “Diagnosing Women’s Health Care” Kaiser Vice President and Director of Women's Health Policy, Alina Salganicoff, authored an article titled "Diagnosing Women’s Health Care" featured in the National Council of Jewish Women's magazine, NCJW Journal, volume 29. The article highlights the special challenges that many women face in affording and accessing comprehensive health care in the U.S. It discusses the state of women's health coverage, emerging issues for…

  • NPR/KFF/HSPH Survey: Public Views on SCHIP Reauthorization: Summary

    Poll Finding

    This summary provides an overview of the results of an October 2007 survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health on the public’s views and opinions of the State Children’s Health Insurance Program and the pending legislation surrounding its reauthorization. Summary (.pdf)

  • Explaining Health Care Reform: Questions About Medicaid’s Role

    Issue Brief

    Medicaid plays a major role in covering more of the uninsured under the new health reform law. The new law includes a significant expansion of Medicaid, an individual requirement to obtain health insurance, and subsidies to help low-income individuals buy coverage through newly established Health Benefit Exchanges. This brief explains the how Medicaid works today and answers some key questions about Medicaid’s role in health reform. Issue Brief (.pdf)

  • How Will Uninsured Parents Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured parents and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Building an Express Lane Eligibility Initiative: A Roadmap of Key Decisions for States

    Issue Brief

    The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provides states new options to reach and enroll the estimated 5 million eligible but uninsured low-income children into Medicaid and CHIP. One key tool provided to states by the law is Express Lane Eligibility (ELE), which allows state Medicaid and CHIP agencies to borrow and rely on eligibility findings from other need-based programs, such as Head Start and the National School Lunch Program, to determine…

  • Resources Examine Medicaid Enrollment Growth And State Budget Pressures

    Fact Sheet

    This package of resources examines the substantial enrollment growth in Medicaid between June 2008 and June 2009 and provides a mid fiscal-year 2010 update on key state Medicaid issues, including the impacts of the economic downturn. News ReleaseWith the country in a deep recession, nearly 3.3 million more people were enrolled in state Medicaid programs in June 2009 compared to the previous June, according to a new analysis, Medicaid Enrollment: June 2009 Data Snapshot (updated for…