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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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  • Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah

    Report

    With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation's 2004 survey of the experiences of Medicaid beneficiaries under Utah's 2002 waiver provide insights into the implications of limited benefits for the low-income population. The results are featured in the March/April edition of…

  • Tracking Prescription Drug Coverage Under Medicare:  Five Ways to Look at the New Enrollment Numbers

    Issue Brief

    Tracking Prescription Drug Coverage Under Medicare: Five Ways to Look at the New Enrollment Numbers This new analysis, which assesses Medicare drug benefit enrollment statistics released Feb. 22 by the U.S. Department of Health and Human Services, examines five different approaches to understanding the Medicare drug coverage numbers: What share of the total Medicare population has creditable prescription drug coverage? What share of the total Medicare population is enrolled in a Medicare drug plan? How…

  • The Transition of Dual Eligibles to Medicare Part D Prescription Drug Coverage: State Actions During Implementation

    Report

    This 50-state survey of Medicaid officials assesses states’ early experience relating to the transition of low-income seniors and people with disabilities enrolled in both Medicaid and Medicare (dual eligibles) to the Medicare Part D drug benefit. Conducted by Health Management Associates, the survey covers the types of problems observed by states during the transition of dual eligibles to the Medicare drug benefit, state actions to correct problems and ensure temporary coverage, and specific data on…

  • Deficit Reduction Act of 2005: Implications for Medicaid

    Issue Brief

    This issue brief summarizes the Medicaid provisions of the budget reconciliation law signed in February 2006 and discusses the implications of the proposed changes. The changes would net reductions of $4.8 billion over the next five years and $26.1 billion over the next ten years from current Medicaid spending. Issue Brief (.pdf)

  • Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid Assets Transfer Practices

    Report

    Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid AssetsTransfer Practices In the Deficit Reduction Act of 2005, Congress tightened Medicaid asset transfer rules for individuals qualifying for Medicaid assistance with nursing home bills. Research on asset transfer shows a low incidence of asset transfers and limited cost savings from tightening such rules. But, because of demographic trends that will increase pressure on Medicaid and concerns that the Medicaid program may be financing care for…

  • Private Long-Term Care Insurance: A Viable Option for Low and Middle-Income Seniors?

    Issue Brief

    In the Deficit Reduction Act of 2005, the federal government made it harder for individuals to qualify for Medicaid nursing home benefits by increasing penalties on individuals who have transferred assets for less than fair market value during the past five years and by making individuals with home equity above $500,000 ineligible for nursing home benefits. The legislation also lifts the moratorium on the number of states that may operate Long-Term Care (LTC) Partnership Programs,…

  • Resources on Medicaid Policy Changes in the Federal Budget Reconciliation Bill

    Issue Brief

    The Foundation's Kaiser Commission on Medicaid and the Uninsured has collected resources related to the Medicaid policy changes in the budget reconciliation law, Deficit Reduction Act of 2005. Deficit Reduction Act of 2005: Implications for Medicaid West Virginia Medicaid State Plan Amendment: Key Program Changes and Questions KYHealth Choices Medicaid Reform: Key Program Changes and Questions Reports Explore Long-Term Care Issues Included in the Deficit Reduction Act The Nuts and Bolts of Making Medicaid Policy…