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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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  • 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)

  • Federal Support for Health Information Technology in Medicaid: Key Provisions in the American Recovery and Reinvestment Act

    Issue Brief

    The American Recovery and Reinvestment Act of 2009 (ARRA) includes an unprecedented nearly $47 billion federal investment in health information technology initiatives. This e-health snapshot provides an overview of the health information technology provisions in the law that have direct implications for Medicaid. Health Information Technology (HIT) offers the promise of potential improvements in quality of care as well as increased efficiencies in care and cost savings. Medicaid, which covers nearly 60 million people, can…

  • Rising Health Pressures in an Economic Recession

    Event Date:
    Event

    As millions of people lose their jobs and job-based health insurance during the recession, the Kaiser Family Foundation has several reports and a video that shed light on the rising toll on American families and the public programs that many depend on to fill the gap during times of crisis. Rising Health Pressures in an Economic Recession: A 360-Degree Look at Four Communities, and a companion video, On the Edge: Health Care in the Recession…

  • Health Reform Opportunities: Improving Policy for Dual Eligibles

    Issue Brief

    As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare. Navigating two programs with different rules and financing incentives is complex for beneficiaries and providers, impedes efforts to improve care coordination and results in cost-shifting between programs that…

  • Rising Health Pressures in an Economic Recession: A 360-Degree Look at Four Communities

    Report

    This report draws on interviews and focus groups in four communities to examine at the grassroots levels the experiences of families, employers, safety-net providers and community organizations in four U.S. communities hard hit by the recession. The communities are Beloit, Wisc.; Tampa-St. Petersburg, Fla.; Long Island, N.Y.; and Sonoma, Calif. The report explores the financial and personal struggles of families who have suffered economic reversals and lost health coverage, forcing many to juggle bills and…

  • New Option for States to Provide Federally Funded Medicaid and CHIP Coverage to Additional Immigrant Children and Pregnant Women

    Fact Sheet

    This fact sheet provides state-level data from a Kaiser survey that found that a large number of states are using state funds to provide health coverage to legal immigrant children and pregnant women through Medicaid, CHIP or another state program. Under the Children's Health Insurance Program Reauthorization Act of 2009, states now have the option to provide federally matched Medicaid or CHIP to some or all of the legal immigrants they have been covering solely…

  • Pulling it Together: Teaching An Old Dog New Tricks

    Perspective

    Way back in the eighties when I was Human Services Commissioner in New Jersey, I established something called the Garden State Health Plan (GSHP).  It was the first — and I think the only — federally qualified state-run HMO for Medicaid beneficiaries.  One goal of the GSHP was to reallocate the Medicaid dollar, giving more to primary care physicians who at the time were paid $9 for a general office visit, and a little less…

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • CHIP TIPS: New Federal Funding Available to Cover Immigrant Children and Pregnant Women

    Issue Brief

    This brief examines a new option under the Children's Health Insurance Program Reauthorization Act of 2009 that allows states to receive federal funds for providing Medicaid and CHIP coverage to lawfully residing immigrant children and pregnant women regardless of when they entered the country. Previously, states had been prohibited from using federal Medicaid or CHIP funds to cover legal immigrants who had been in the country fewer than five years. The brief, the fifth installment…

  • Money Follows the Person: An Early Implementation Snapshot

    Issue Brief

    This issue brief examines the early successes and challenges of the Money Follows the Person Demonstration (MFP), a Medicaid initiative enacted into law in 2006 that gives states enhanced federal support to balance their Medicaid long-term care programs by providing more services in the community and fewer in institutional settings. A 2008 Kaiser Commission on Medicaid and the Uninsured survey of 29 states receiving MFP grants turned up several key findings, including that several hundred…