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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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  • Medicaid: Addressing the Future

    Event

    Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, testified before the U.S. Senate Special Committee on Aging on the future of Medicaid and its role for low-income Americans, particularly the elderly. Testimony (.

  • National Survey of the Public’s Views About Medicaid

    Poll Finding

    National Survey of the Public's Views About Medicaid This national survey of the public reveals that Americans view the Medicaid program positively and are reluctant to see state and federal cuts to the program. The survey also asked the public about their knowledge of the Medicaid program.

  • Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline: June 2004 – December 2006 Key Dates

    Report

    Key Implementation Dates for the Medicare Prescription Drug Benefit This timeline presents important dates and deadlines of key implementation activities related to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It runs from the beginning of 2005 through the end of 2006, the first year of the new Medicare drug benefit.

  • Medicaid Enrollment and Spending by “Mandatory” and “Optional” Eligibility and Benefit Categories

    Report

    Medicaid Enrollment and Spending by "Mandatory" and "Optional" Eligibility and Benefit Categories This report presents new estimates of the proportion of Medicaid beneficiaries and spending that is mandatory and optional to promote an increased understanding of how Medicaid restructuring proposals might affect the various groups and services covered by the program. Report (.

  • Stresses to the Safety Net:  The Public Hospital Perspective

    Report

    The nation’s safety net financing is fragmented; consequently, providers must knit together resources from many different funding sources to create a stream of revenue to cover the costs of providing a very broad range of services. This report describes those sources of revenue, documenting that nearly 40% of all safety net revenues are from Medicaid.

  • Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences

    Issue Brief

    Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. This brief reviews the key findings from this recent activity, including the impact on enrollment in public coverage programs, access to care, and providers. Issue Paper (.

  • Medicaid’s Role in Long-Term Care

    Other Post

    Medicaid and Long-Term Care While Medicaid is the nation’s major source of financing for long-term care services, paying for over 40% of total long-term care, its role is not well understood. Misperceptions on who qualifies and what is covered are common.