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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.

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.

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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  • Medicaid Beneficiaries and Access to Care

    Fact Sheet

    The health reform law relies on a large expansion of Medicaid to reach many low-income uninsured people, many of them adults. This fact sheet summarizes Medicaid beneficiaries' experience in obtaining access to care, a subject that is of keen interest in view of the planned expansion of the program.

  • Medicaid and Children’s Health Insurance Program Provisions in the New Health Reform Law

    Issue Brief

    This brief compares the Medicaid and Children's Health Insurance Program provisions in the new health reform law with pre-reform law governing those programs. The analysis focuses on Medicaid coverage and financing changes; how Medicaid and CHIP will interface with a new health insurance exchange and other Medicaid benefits and access changes.

  • Managed Care and Low-Income Populations: A Case Study Of Managed Care In Florida

    Report

    This study is part of a larger initiative, the Kaiser/Commonwealth Low-Income Coverage and Access project funded by both the Henry J. Kaiser Family Foundation and The Commonwealth Fund, to gauge the impact of health restructuring on access and health insurance coverage for low-income populations in seven states through surveys, focus groups and case studies.

  • Talking With Kids About Tough Issues

    Report

    Talking With Kids About Tough Issues is a national campaign to support parents by Children Now and the Henry J. Kaiser Family Foundation. This guide for parents offers practical, concrete tips and techniques for talking easily and openly with young children ages 8 to 12 about tough issues: sex, HIV/AIDS, violence, drugs and alcohol.

  • Federal Budget Chartbook 2001

    Report

    A new chart book examines Fiscal Year 2002 budget proposals by President Bush and Congress, focusing on their impact on health programs. It provides both an examination of how health care programs fit into the overall U.S. budget and a review of past budget trends and future projections for government health care programs.

  • The Uninsured in Rural America

    Fact Sheet

    Summarizes the number of uninsured individuals in rural America, who they are, and the barriers to coverage they experience.

  • CHIP Program Enrollment: June 2000

    Report

    The report reveals that the total number of children enrolled in state CHIP programs had grown to 2.3 million by June 2000, showing a steady increase in enrollment. The report is part of a larger project to track Medicaid and CHIP enrollment in all 50 states.

  • Health Coverage for Low-Income Children

    Fact Sheet

    This fact sheet, last updated in March 2001, discusses health insurance status of low-income children and reviews current programs to provide coverage to this population.

  • Medicaid’s Disabled Population and Managed Care

    Fact Sheet

    Medicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them.

  • Medicaid and Managed Care

    Fact Sheet

    This fact sheet provides an overview of the Medicaid program's increasing reliance on managed care to deliver services.