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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.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

Tracking Medicaid Work Requirements:
Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

understanding medicaid

5 Facts: Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

5 Facts: Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

5 Facts: Medicaid and Immigrants

Confusion persists about immigrants’ eligibility for federal programs. This brief helps readers understand how current Medicaid policy affects immigrants as well as the potential impacts of policy changes under the Trump administration.

5 Facts: Medicaid and Rural Areas

Approximately 66 million people live in rural areas – about 20% of the U.S. population. Nearly 1 in 4 of them have Medicaid, a higher share than in urban areas (24% vs 21%).

5 Facts: Nursing Facilities

The substantial Medicaid savings in the reconciliation bill that has been passed by the House could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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.

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  • 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.

  • Restructuring Medicaid: Key Elements and Issues in Section 1115 Demonstration Waivers

    Issue Brief

    This policy brief provides background on Section 1115 Medicaid waiver activity, discusses the common provisions of the approved and proposed Section 1115 waivers since 1993, and briefly summarizes the current application of Section 1115 AFDC waivers. It also examines implications of the Section 1115 waivers on the Medicaid program and its beneficiaries.

  • Where is Medicaid Spending Headed? – Report

    Report

    Where is Medicaid Spending Headed? Prepared for: The Kaiser Commission on the Future of Medicaid Prepared by: John Holahan and David Liska, The Urban Institute December 1996 In 1995, the United States witnessed a major debate over the future course of the Medicaid program.

  • Where is Medicaid Spending Headed?

    Other Post

    Enrollment Another important factor is that Medicaid enrollment increases slowed substantially. After increasing by 7.9 percent annually between 1988 and 1992, enrollment growth slowed to 5.3 percent per year in the following three years (Table 2). Table 3 shows that the rate of growth in enrollment of Medicaid beneficiaries slowed between 1991 and 1995.

  • Where is Medicaid Spending Headed?

    Fact Sheet

    This content package page includes a report providing an overview of the changes in Medicaid expenditures since 1988, including an analysis of the slowdown in Medicaid growth since 1992. Also included in the package is a press release, chart pack and fact sheet on Medicaid spending and enrollment trends.

  • Where is Medicaid Spending Headed? – Fact Sheet

    Fact Sheet

    Medicaid Enrollment and Spending Growth Overview In 1995, Medicaid provided health and long-term care for 34.8 million low-income, elderly, and disabled Americans at a cost of $157.3 billion, $151.8 billion for services and $5.5 billion for administration. After expanding considerably in the early 1990's, Medicaid spending and enrollment growth have slowed markedly.

  • Medicaid Update: Expenditures and Beneficiaries in 1994 – Policy Brief

    Issue Brief

    Medicaid Expenditures and Beneficiaries: 1994 Update October 1998 Medicaid is the nation's major public financing program for low-income Americans. After several years of rapid increase in the early 1990s, enrollment and spending growth have moderated and returned to historical levels. For the second consecutive year, annual growth in Medicaid spending was under 10 percent.