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2025 Reconciliation Law

How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?

This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10 million in 2034. That number would rise to over 14 million if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.

ANALYSIS

Allocating Federal Medicaid Spending Reductions Across States

Policy Tracker

Medicaid Provisions in the 2025 Budget Reconciliation Law

ANALYSIS

How Might Federal Medicaid Cuts Affect Rural Areas?

From Drew Altman

Can Democrats Make Medicaid and ACA Cuts Their Winning Political Issue?

Work Requirements

How Will States Implement Medicaid Work Requirements?

Event Date:

Four experts, including two state Medicaid directors, will join Health Wonk Shop moderator Larry Levitt in an hour-long discussion of how states will go about implementing new Medicaid work requirements.

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.

  • Adults with Mental Illness

    Options under consideration in Congress to significantly reduce Medicaid spending could have major implications for adults who live with mental illness.

  • 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.

The Essentials

  • 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.

  • 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: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 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.

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  • Key Questions About the New Medicaid Eligibility Pathway for Uninsured Coronavirus Testing

    Issue Brief

    In response to the need to increase access to testing during the COVID-19 pandemic, recent federal legislation, the Families First Coronavirus Response Act, amended by the Coronavirus Aid, Relief, and Economic Security Act, creates a new optional Medicaid eligibility pathway, with 100% federal matching funds, for states to cover coronavirus testing and testing-related services for uninsured individuals. This new option is available from March 18, 2020 through the end of the public health emergency period. This issue brief answers key questions about how the new eligibility pathway is being implemented, drawing on frequently asked questions issued by the Centers for Medicare and Medicaid Services.

  • How Can Lessons from Medicaid Help Connect People to Unemployment Insurance?

    Issue Brief

    Millions of people are losing jobs due to the coronavirus pandemic and seeking financial assistance through Unemployment Insurance (UI) programs. While UI can provide an important source of temporary assistance for many people losing jobs, there have been reports of major challenges accessing UI benefits. Over time, states have significantly streamlined Medicaid and the Children’s Health Insurance Program (CHIP) application and enrollment processes to overcome many similar challenges to connect eligible people to health insurance coverage. As such, previous experience enrolling individuals into Medicaid and CHIP can provide lessons learned that could help inform efforts to connect people to UI. This brief summarizes some key lessons learned and discusses how states could potentially apply these lessons to UI.

  • How Can Trump Administration Regulations Be Reversed?

    Issue Brief

    With the inauguration of President Biden and Democrats holding a slim majority in Congress, policymakers are likely to consider whether and how to reverse various health policy regulations issued by the Trump Administration.

  • Analyzing Recent Trends in Medicaid/CHIP Applications: What We Do and Do Not Know

    Issue Brief

    This data note discusses changes in the number of applications for Medicaid/CHIP coverage during the coronavirus pandemic. Although enrollment in Medicaid/CHIP has increased steadily by more than 6 million individuals (9%) from February to September 2020, the total number of Medicaid/CHIP applications has decreased by more than 150,000 (-6%) in the same time period. The decline in applications might on the surface suggest that fewer people are applying for coverage even in the face of large job and income losses, but data limitations – in particular, the fact that application statistics do not distinguish between new signups and renewals – make it difficult to draw any clear conclusions.

  • Medicaid Work Requirements at the U.S. Supreme Court

    Policy Watch

    Though the Trump Administration has left office, the Supreme Court is set to decide whether Medicaid work requirements – a controversial policy advanced by the Trump Administration – are legal.

  • Is the End of the Long-Term Care Crisis Within Sight? New COVID-19 Cases and Deaths in Long-Term Care Facilities Are Dropping

    Policy Watch

    This analysis compares trends in new COVID-19 cases and deaths among nursing facility residents with trends in all other new COVID-19 cases and deaths excluding nursing facility residents through February 7, 2021. This analysis shows a marked divergence in new cases and deaths per week between nursing facility residents and the rest of the US population since December 2020. This drop in new deaths and cases in nursing facility residents coincides with the start of vaccine administration in LTCFs, suggesting a link between the two, although the trends could also be influenced by other factors.

  • Recent Medicaid/CHIP Enrollment Declines and Barriers to Maintaining Coverage

    Issue Brief

    Recently there have been declines in Medicaid and CHIP enrollment, reversing a previous trend of increases following implementation of the ACA. Experiences in some states suggest that renewal process requirements and growing use of periodic eligibility checks may be contributing to disenrollment among people who are still eligible for coverage as well as increased churn in coverage. This brief reviews current rules and state processes related to renewal and periodic eligibility reviews and discusses potential process issues that may be contributing to Medicaid and CHIP enrollment declines.