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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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  • COVID-19: Expected Implications for Medicaid and State Budgets

    Policy Watch

    Rising unemployment due to COVID-19 has implications for state budgets and Medicaid, as individuals who lose income may qualify for Medicaid or become uninsured. The magnitude of the coverage changes, as well as fiscal impact, is expected to be even greater than in the Great Recession.

  • Why it Matters: Tennessee’s Medicaid Block Grant Waiver Proposal

    Issue Brief

    On November 20, 2019, Tennessee submitted an amendment to its longstanding Section 1115 Waiver that would make major financing and administrative changes to its Medicaid program. The Centers for Medicare and Medicaid Services (CMS) certified the waiver as complete and opened a federal public comment period through December 27, 2019. Most significantly, Tennessee is requesting to receive federal funds in the form of a “modified block grant” and to retain half of any federal “savings”…

  • Eligibility for ACA Health Coverage Following Job Loss

    Issue Brief

    As unemployment claims skyrocket amid the coronavirus (COVID-19) crisis, this analysis examines the potential loss of job-based coverage among people in families where someone lost employment between March 1 and May 2 and estimate their eligibility for ACA coverage as of May and January 2021, when most will have exhausted their unemployment benefits.

  • Impact of Coronavirus on Community Health Centers

    Issue Brief

    Community health centers are a national network of safety net primary care providers that fill an important role in national, state, and local responses to the coronavirus pandemic. This brief presents findings from new data that provide insights into how health centers are adapting their services in response to the pandemic and how coronavirus is affecting their operations and long-term financial outlook with patient visits and revenue from those visits dropping precipitously.

  • What You Need to Know About the Medicaid Fiscal Accountability Rule (MFAR)

    Issue Brief

    On November 18, 2019, the Trump Administration released a proposed rule called the Medicaid Fiscal Accountability Regulation (MFAR). This brief provides some context on Medicaid financing, an overview of current state payment and financing rules, the provisions in the rule and potential implications for considerations.

  • 50-State Survey Finds States Have Upgraded Medicaid Enrollment and Eligibility Systems and Begun Resolving Initial ACA Implementation Issues, Although Challenges Remain

    News Release

    Over its first two years, the Affordable Care Act (ACA) has triggered increases in Medicaid eligibility levels and upgrades in states’ Medicaid eligibility and enrollment systems, making it easier for individuals to enroll in Medicaid and producing faster eligibility decisions, according to a new Kaiser Family Foundation survey of Medicaid and Children’s Health Insurance Program eligibility levels and enrollment, renewal and cost-sharing policies. The 14th annual 50-state survey, conducted by the Foundation’s Kaiser Commission on…

  • Income Eligibility Levels for Children in Medicaid/CHIP

    Feature

    income-eligibility-levels-for-children-in-medicaid-chip-january-2017 Download Source Based on  results from a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, 2017.

  • Takeaways From Alaska’s Medicaid Expansion

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses the implications of the governor of Alaska’s decision to move ahead unilaterally with Medicaid expansion. All previous columns by Drew Altman are available.

  • Key Data on Health and Health Coverage in South Carolina

    Fact Sheet

    This fact sheet draws on data from “Health and Health Coverage in the South: A Data Update” to highlight findings for South Carolina. The findings show the current status of health and health coverage in the state and the potential coverage gains that may be achieved through the Affordable Care Act.