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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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  • Challenges of Providing Health Coverage for Children and Parents in a Recession: A 50 State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2009

    Report

    Overall, more than one-third of the states (19 states) took steps last year to increase access to health coverage for low-income children, pregnant women and parents –- including 15 states that authorized or implemented coverage expansions. At the same time, 10 states enacted at least one measure to restrict access. The report also examines trends in parental coverage and state outreach efforts, including the use of technology to facilitate enrollment. Full Report (.pdf) Data Tables…

  • Chartpack — The Public’s Health Care Agenda for the New President and Congress

    Poll Finding

    Chartpack -- The Public's Health Care Agenda for the New President and Congress This chartpack provides the key findings from the survey of the public's attitudes regarding the health care agenda for President Obama and the new Congress in 2009. It assesses the relative priority placed on health care by the American public as part of addressing the economic recession and as a large scale reform issue. The public's priorities for health care reform and…

  • Toplines — The Public’s Health Care Agenda for the New President and Congress

    Poll Finding

    Toplines -- The Public's Health Care Agenda for the New President and Congress This document contains the detailed toplines from The Public's Health Care Agenda for the New President and Congress poll. The poll involved a nationally representative random sample of 1,628 adults ages 18 and older who were interviewed by telephone between December 4 and 14, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points. For…

  • The Role of Medicaid in State Economies: A Look at the Research

    Issue Brief

    This policy brief synthesizes the results of 29 studies in 23 states that examine the role Medicaid plays in state and local economies. These studies estimate the economic stimulus derived from Medicaid spending, and also analyze the adverse effects on the state economy from reducing Medicaid spending. This policy brief provides an overview of Medicaid financing, explains the methods used to assess economic impact and summarizes the main findings from the research. Executive Summary (.pdf)…

  • Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession

    Report

    This report relays the perspective of leading state Medicaid directors to describe the fiscal strain on Medicaid and other safety-net programs as enrollment swells and state tax revenues shrink, raising the prospect of program cutbacks. It draws on focused interviews with leading Medicaid directors in November 2008. It augments the most recent Medicaid budget survey report that was based on a survey and interviews with all state Medicaid directors in July and August 2008, at…

  • Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees

    Issue Brief

    This issue brief illuminates the emotional and pocketbook struggles of families who have suffered financial reversals and lost health coverage in the economic recession forcing many to juggle bills, skip prescription medications and postpone visits to the doctor while they scramble to find a new job. Many who once had steady employment and incomes have had to turn to Medicaid and the State Children’s Health Insurance Program for the first time, even as those programs…

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Short Term Options for Medicaid in a Recession

    Issue Brief

    This policy brief discusses several short-term options for strengthening Medicaid at time when the economic recession has increased demand for the program and constrained state budgets. It details potential steps such as increasing federal funding, easing enrollment barriers and temporarily expanding coverage. Policy Brief (.pdf)

  • Making the Most of Medicaid: Promoting the Health of Women and Infants With Preconception Care

    Report

    This article examines the evolution and current role of Medicaid in improving access to preconception care for low-income women. It reviews Medicaid's eligibility policy and benefits of relevance to women of reproductive age, and discusses challenges facing the program. Authors Alina Salganicoff, vice president and director of women's health policy for the Kaiser Family Foundation, and Jane An, a research assistant at the Foundation, also examine potential opportunities to use the Medicaid program to promote…

  • Health Coverage in an Economic Downturn: Impact of Tight Budgets on Families and States

    Fact Sheet

    The economic downturn has strained family finances and prompted some Americans to cut back on medications and forgo preventive care and visits to the doctor. At the same time, the downturn has triggered declines in tax revenue that inhibit states’ ability to meet rising Medicaid program costs as enrollment spikes during economic hard times. Many states are expected to struggle to close budget gaps despite moves by Congress and the Obama Administration to temporarily boost…