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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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  • CHIP TIPS: CHIP Financing Structure

    Issue Brief

    This brief, the fourth in a series, examines important changes to CHIP’s financing structure under the Children’s Health Insurance Program Reauthorization Act of 2009. The law includes a number of important programmatic and financing changes that affect both Medicaid and CHIP. Among the most important changes include significant new funding for the CHIP program, changes in the formula for distributing CHIP funds among states and a new option for states to decide whether to use…

  • Low-Income Adults Under Age 65 – Many are Poor, Sick, and Uninsured

    Issue Brief

    This policy brief from the Kaiser Commission on Medicaid and the Uninsured examines the characteristics and insurance coverage of low-income adults under age 65, a group numbering more than 50 million people. Members of this group are more likely to be in poor health than other Americans and are the least likely to have health insurance. Nearly a third are from families earning less than twice the poverty level. Fifteen percent live in poverty. Although…

  • Filling In The Long-Term Care Gaps

    Event Date:
    Event

    At a June 3 hearing of the Senate Special Committee on Aging, Diane Rowland, Executive Vice President of the Kaiser Family Foundation and Executive Director on the Kaiser Commission on Medicaid and the Uninsured, testified on the key challenges to providing a larger role for private long-term care insurance in financing long-term care for the elderly and people with disabilities. Her testimony coincided with the release of a policy brief on long-term care financing by…

  • Examing the Role of Private Long-Term Care Insurance in the Financing of Long-Term Care

    Issue Brief

    As the long-standing gap between Americans’ need for long-term care services and the public and private funding available to pay for them grows ever wider, this policy brief from the Kaiser Commission on Medicaid and the Uninsured examines the fundamentals of private long-term care insurance. The brief describes the results of a study exploring how consumers buy policies, how much policies cost and how they work, and what regulations exist to protect consumers. It also…

  • Closing the Long-Term Care Funding Gap: The Challenge of Private Long-Term Care Insurance

    Issue Brief

    This policy brief from the Kaiser Commission on Medicaid and the Uninsured examines the fundamentals of private long-term care insurance. It describes the results of a study exploring how consumers buy policies, how much policies cost and how they work, and what regulations exist to protect consumers. It also discusses some key challenges that policymakers face when considering whether to enlarge the role of private long-term care insurance in financing long-term care. Policy Brief (.pdf)

  • Pulling it Together: About Kaiser Health News

    Perspective

    There is lots of apocalyptic talk these days about the collapse of the newspaper industry and the challenges facing news organizations.  There is even talk of the unimaginable, my hometown paper The Boston Globe shutting down. Surely they know that Red Sox Nation cannot exist without the Globe Sports pages. All kinds of solutions have been proposed, from micro-payments for news stories like songs on iTunes to foundation-endowed daily newspapers.  There is growing talk of…

  • Expanding Health Coverage for Low-Income Adults: Filling the Gaps in Medicaid Eligibility

    Issue Brief

    Low-income adults (those with incomes below 200 percent of poverty, or $33,200 for a family of three in 2007) account for just over half of the non-elderly uninsured in the United States. This brief reviews the health coverage of non-elderly low-income adults and discusses the implications for national health reform efforts of broadening coverage for this population by filling gaps in Medicaid eligibility. Low-income adults are more than twice as likely to be uninsured as…

  • The Coverage and Cost Impacts of Expanding Medicaid

    Report

    This paper quantifies the impacts on coverage and cost of expanding Medicaid to cover more of the low-income uninsured, including adults, at various income levels and with improved participation rates. The analysis models two primary options to expand Medicaid (250% FPL for children, 100% FPL for adults; 300% FPL for children, 150% for adults) as well as the same options with no change for children. Report (.pdf)

  • Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid

    Issue Brief

    This policy brief examines the structure and experience of Community Care of North Carolina, an enhanced medical home model of care that North Carolina began implementing in 1998 as part of its Medicaid program. Evaluations of the initiative, which includes a heavy emphasis on care coordination, disease and care management and quality improvement, suggest that it has resulted in both improved care and cost savings. The program provides important lessons for broader health reform efforts…

  • New Kaiser Resources Examine Medicaid as a Platform for Health Reform

    Issue Brief

    These related research papers examine the policy opportunities for expanding Medicaid to cover more low-income and high-need people in ways that would enable the program to serve as a platform for larger national health reform efforts. As congressional leaders work on proposals for universal coverage, some policymakers have suggested that strengthening Medicaid’s coverage of the poorest Americans and those with special health needs could provide a base for broader health reform efforts to expand coverage,…