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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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  • 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 (.pdf)

  • 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. A fact sheet and a Q & A sheet about Medicaid’s role in long-term care assistance provide basic information on the topic. Medicaid’s Role in Long-Term Care: Q & A Medicaid and Long-Term Care…

  • Medicaid’s Role in Long-Term Care: Q & A

    Fact Sheet

    Financing long-term care for the nearly 10 million Americans who need services and support to assist them in life’s daily activities continues to challenge the nation. 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. A new question and answer fact sheet about Medicaid’s long-term care assistance…

  • Migrant and Seasonal Farmworkers:  Health Insurance Coverage and Access to Care

    Report

    Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care Nearly three million workers earn their living through migrant or seasonal farm labor. Migrant and seasonal farmworkers and their families confront health challenges stemming from the nature of their work, their extreme poverty and mobility, and living and working arrangements that impede access to health coverage and care. This brief provides an overview of migrant and seasonal farmworkers and the health challenges they face…

  • Current Issues in Medicaid Financing

    Report

    In recent years there has been much discussion about states’ use of creative financing to draw down additional federal funds for Medicaid financing. Some suggest a curb on these practices and the President’s FY2006 budget includes provisions targeting intergovernmental transfers (IGTs). The Commission has produced a fact sheet and briefs on Medicaid financing issues. Medicaid Financing Issues: Intergovernmental Transfers and Fiscal Integrity - An Overview of IGTs, UPLs, and DSH - Issue Brief Medicaid's Federal-State…

  • MaineCare and Its Role in Maine’s Healthcare System

    Report

    This paper explores the role of MaineCare, Maine’s Medicaid program, in the state’s health care system and the relationship between MaineCare and the Dirigo Health plan that the state approved in 2003. Report (.pdf)

  • One State’s Medicaid Managed Care Formulary Operations:  A Look at Pennsylvania, 2001-2002

    Report

    One State’s Medicaid Managed Care Formulary Operations: A Look at Pennsylvania, 2001-2002 This report examines formulary implementation under mandatory Medicaid managed care in Pennsylvania between 2001 and 2002. It looks at one state during a yearlong period; formulary operations are likely to vary across states and programs and over time. The report includes findings about Pennsylvania’s formulary operation and observations about improving the system. Report (.pdf)

  • Cost Containment Strategies For Prescription Drugs: Assessing The Evidence In The Literature

    Report

    This report describes and reviews various options to address prescription drug spending growth, including a description of each cost-containment strategy, its use by private or public payers, and a discussion of known evidence about its effectiveness or cost-saving potential. It was prepared for the Kaiser Family Foundation by Jack Hoadley, Ph.D., of the Health Policy Institute at Georgetown University. Report (.pdf)