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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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  • Today’s Topics In Health Disparities: Is the Health Care System Ready for Health Reform?

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    Event

    On Wednesday, November 4, at 1 p.m. ET, this Today's Topics In Health Disparities live webcast examined how ready the health care system is for the influx of newly covered individuals that health reform aims to deliver. In the health care proposals being considered by Congress, changes to Medicaid alone could mean as many as 15 million people would become newly eligible for the program and many live in medically underserved areas. The program will…

  • Medicaid and State Budgets: From Crunch to Cliff

    Fact Sheet

    This fact sheet discusses the status of Medicaid and state budgets in light of the continuing recession and the federal fiscal relief provided to state Medicaid programs through the American Recovery and Reinvestment Act (ARRA). The ARRA money has proved to be critical in helping states address budget shortfalls, preserve Medicaid eligibility and soften program cuts. But ARRA funds are set to expire on Dec. 31, 2010, creating a major cliff in state financing that…

  • The Sleeper in Health Reform: Long-Term Care and the CLASS Act

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    Event

    The Kaiser Family Foundation briefing examines a little-noticed but major provision in two leading health reform bills that would change the way that the U.S. pays for long-term care. The provision, known as the Community Living Assistance Services and Supports (CLASS) Act, would establish a national voluntary insurance program that would allow for voluntary pre-financing of long-term care through payroll deductions and then provide a cash benefit to purchase services. The briefing included a summary…

  • Oral Histories: Report from a Dental Fair

    Video

    This video profiles patients attending a dental fair in rural Virginia and highlights the impact of lack of coverage for oral health services. Uninsured adults have vast oral care needs, and untreated dental problems can have serious health, employment and social consequences.

  • The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession

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    Event

    This annual 50-state survey finds that number of people on Medicaid and state spending on the program are climbing sharply as a result of the recession, straining state budgets and pressuring officials to curb costs despite increased financial help from the federal government through the American Recovery and Reinvestment Act (ARRA). The survey finds that these trends are expected to continue well into the 2010 fiscal year, with the slumping economy contributing to the loss…

  • Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts

    Issue Brief

    This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS). Among the key ideas drawn from a working group discussion at the Foundation are the benefits of: • providing additional federal financing to states to provide Medicaid HCBS and to administer these benefits; • simplifying the process for states…

  • Medicaid Expenditures Increased by 5.3% in 2007, Led By Acute Care Spending Growth

    Issue Brief

    This brief presents analysis of the latest available Medicaid spending and enrollment data to examine recent trends in program enrollment, total spending, spending by service, and spending per enrollee. The focus is on spending changes between 2006 and 2007, with historical context also provided. After Medicaid spending declined in 2006 for the first time in the program's history, spending climbed by 5.3 percent in 2007. In raw dollars, spending increased to $330.8 billion in 2007,…

  • Key Issues in Medicaid and Home and Community-Based Services and Support

    Issue Brief

    These briefs examine current issues in providing more people who need long-term care services and supports access to these Medicaid services in home and community-based settings rather than in institutional ones. The first brief, Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts , highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates…

  • Efforts in States to Promote Medicaid Community-Based Services and Supports

    Issue Brief

    This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states. Brief (.pdf)