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2025 Reconciliation Law

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.

ANALYSIS

Allocating Federal Medicaid Spending Reductions Across States

Policy Tracker

Medicaid Provisions in the 2025 Budget Reconciliation Law

ANALYSIS

How Might Federal Medicaid Cuts Affect Rural Areas?

From Drew Altman

Can Democrats Make Medicaid and ACA Cuts Their Winning Political Issue?

Work Requirements

How Will States Implement Medicaid Work Requirements?

Event Date:

Four experts, including two state Medicaid directors, will join Health Wonk Shop moderator Larry Levitt in an hour-long discussion of how states will go about implementing new Medicaid work requirements.

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.

  • Adults with Mental Illness

    Options under consideration in Congress to significantly reduce Medicaid spending could have major implications for adults who live with mental illness.

  • 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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  • How Will Medicare-for-all Proposals Affect Medicaid?

    Issue Brief

    As the debate over the future direction of our health care system heats up leading into the 2020 Presidential election, several Democratic proposals to create a single, federal, universal health insurance program known as Medicare-for-all have garnered significant attention. These proposals would replace most current public and private health insurance with a new federal program that would guarantee health coverage for all or nearly all U.S. residents. However, many details about how a new public program would be implemented and financed are not yet known. While much attention has focused on the implications of ending private insurance and Medicare, the debate has largely ignored the effects on the low-income and vulnerable populations covered by Medicaid and the broader implications for states of eliminating the Medicaid program.

  • Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

    Feature

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and those adopted for implementation for FY 2018 (which began for most states on July 1, 2017). Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits (including prescription drug policies), and opioid harm reduction strategies.

  • 5 Ways the Graham-Cassidy Proposal Puts Medicaid Coverage At Risk

    Fact Sheet

    The Graham-Cassidy proposal to repeal and replace the Affordable Care Act (ACA) is reviving the federal health reform debate and could come up for a vote in the Senate before the budget reconciliation authority expires on September 30. This fact sheet describes five ways in which the proposal revamps and cuts Medicaid, redistributes federal funds across states and eliminates coverage for millions of poor Americans.

  • Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience

    Issue Brief

    This issue brief considers the implications of conditioning Medicaid eligibility on satisfying a work requirement, drawing on state experience with TANF enrollees subject to a work requirement over the past two decades and data about work and the role of health coverage among Medicaid enrollees today.

  • ACA Open Enrollment Matters for Medicaid Coverage, Too

    Policy Watch

    President Biden’s January 28th executive order to reopen enrollment in the federal ACA Marketplace from February 15 through May 15, combined with $50 million in federal spending on outreach and education about ACA coverage options, has the potential to reach millions of people who were uninsured prior to or have lost coverage during the pandemic. As of 2019, there were 29 million non-elderly uninsured people, and the majority (57%) were eligible for financial assistance through the ACA Marketplaces (33%) or Medicaid (25%). KFF estimates indicate that nearly nine million uninsured people could be eligible for free or subsidized Marketplace coverage during the new enrollment period. Importantly, these actions to facilitate enrollment in ACA Marketplace coverage will also likely lead eligible low-income people to enroll in Medicaid coverage.