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What to Watch

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

The Essentials

  • 5 Facts: Medicaid and Provider Taxes

    This brief describe states’ current provider taxes and how the 2025 reconciliation law changed the federal rules governing them, including potential impacts across states.

  • 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: 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.

  • 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.
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.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • 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.

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  • Mapping Hospital Employment By State

    Issue Brief

    Changes to Medicaid funding, eligibility and enrollment could impact hospital finances. These interactive 50-state maps show the number of hospital employees by state and how hospital employment ranks among industry subsectors. Hospitals employed 6.7 million people in 2023, and more than 100,000 people in each of 23 states.

  • National Survey of Physicians Part IV: Doctors, Payors, and Low-Income Patients

    Poll Finding

    As part of the Kaiser Family Foundation's National Survey of Physicians, this portion of the survey examines differences in provider payment rates from different payors, such as Medicaid, Medicare, and private insurers, and explores providers experiences with these different payors and with providing treatment for uninsured and low-income patients.

  • Is the State Fiscal Crisis Over?  A 2004 State Budget Update – Report

    Issue Brief

    Is the State Fiscal Crisis Over? A 2004 State Budget Update - Issue Brief This paper, which updates a September 2003 analysis by the Rockefeller Institute of Government, finds that although the state fiscal situation is improving, states are by no means out of the woods yet. Issue Brief (.

  • Dual Eligibles Tables: Enrollment and Spending, by State, 2002

    Report

    This set of tables, prepared by the Urban Institue for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state by state data on Medicaid enrollment and expenditures for dual eligibles. Full Set of Tables (.

  • Health Coverage for Individuals Affected by Hurricane Katrina:

    Issue Brief

    A Comparison of Different Approaches to Extend Medicaid Coverage Approaches have been put forward to extend Medicaid coverage to Hurricane Katrina survivors, but they differ significantly regarding the extent to which they extend Medicaid eligibility and in the role of federal funding for coverage of Hurricane survivors.

  • Serving Low-Income Families Through Premium Assistance: A Look At Recent State Activity

    Issue Brief

    This issue paper examines the policies in the HIFA waiver initiative that provide incentives for states to use Medicaid/SCHIP funds to assist in the purchase of private insurance options. It also reports on how states have responded to these new policies and what key policy questions are raised about premium assistance programs. Issue Paper (.

  • Medicaid Matters For Low Income Medicare Beneficiaries: A Video

    Event Date:
    Event

    In this video, Mildred Benham, a 68 year-old dual enrollee who lives in Bloomington, Illinois, describes the role Medicaid plays in providing services that Medicare does not, such as prescription drugs and personal care.