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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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  • KFF Health Tracking Poll: Views of the One Big Beautiful Bill

    Feature

    This poll finds two-thirds of the public view the "One Big Beautiful Bill" legislation unfavorably, and its favorability erodes further when people hear about its potential health impacts. As Congress debates changes to Medicaid and the ACA as part of the bill, each program's popularity is at a record high.

  • Poll: Public Views “Big Beautiful Bill” Unfavorably by Nearly a 2-1 Margin; Democrats, Independents and Non-MAGA Republicans Oppose It, While MAGA Supporters Favor It

    News Release

    Medicaid Work Requirements Are Generally Popular, But Arguments Can Shift Views Nearly two-thirds (64%) of the public holds unfavorable views of the “One Big Beautiful Bill” passed last month by the House, nearly twice the share who view the bill favorably (35%), a new KFF Health Tracking Poll finds. The budget reconciliation bill that includes tax and budget cuts – much of which affect health care – is viewed unfavorably by large majorities of Democrats…

  • 7 Charts About Public Opinion on Medicaid

    Feature

    This data note provides an overview of recent KFF polling on the public’s views of and connections to Medicaid, the federal-state government health insurance for certain low-income adults and children and long-term care program for adults 65 and older and younger adults with disabilities.

  • What are the Implications of the 2025 Budget Reconciliation Bill for Hospitals?

    Issue Brief

    On May 22, 2025, the U.S. House of Representatives passed a budget reconciliation bill that includes significant reductions in federal Medicaid spending to help offset the cost of tax cuts, along with changes to the Affordable Care Act (ACA), immigration reforms and other provisions. This issue brief discusses the potential implications of the bill for hospitals and explains how some hospitals (such as rural hospitals as well as urban hospitals that serve a large share…

  • The Biggest Rollback in Federal Support for Health Coverage Ever

    Quick Insights

    Republicans are not talking about repealing and replacing the ACA anymore, and the budget reconciliation bill doesn't do that, at least not directly. However, the bill would restrict health insurance for many people who have been helped by the ACA, and it would be the biggest rollback in federal support for health coverage ever.

  • KFF Health Tracking Poll: The Public’s Views of Funding Reductions to Medicaid

    Feature

    As Congress works to pass the "One Big Beautiful Bill Act," which includes significant changes to Medicaid and the ACA, the latest KFF Health Tracking Poll examines the views of groups that could be most directly impacted by the impending legislation. The poll finds most of the public is worried about the consequences of federal funding reductions to Medicaid, including rural residents, those with lower incomes, and across partisans.

  • More Than Half of the Public Worries Federal Medicaid Budget Cuts Would Affect Their Family’s Ability to Obtain and Afford Care; More Worry It Will Increase the Uninsured 

    News Release

    As Congress weighs spending cuts and other changes to Medicaid, more than half (54%) of the public say they are worried significant reductions in federal Medicaid spending would negatively affect their family’s ability to obtain and afford health care, a new KFF Health Tracking Poll finds. This includes about three in 10 (29%) who say they are “very worried” about such an outcome.  Democrats (69%) and independents (68%) are much more likely to say they…

  • Make American Health Care Affordable Again

    Perspective

    In this JAMA Health Forum column, Larry Levitt highlights how the Make America Healthy Again agenda aimed at chronic disease does little to address the affordability of health care and that efforts to lower federal spending on health care may worsen the problem, raising out-of-pocket costs for many people with Medicaid and Affordable Care Act coverage.

  • Estimated Medicaid Enrollment Loss From the House Budget Committee Reconciliation Bill, By State

    Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States: House Reconciliation Bill

    Issue Brief

    The Congressional Budget Office’s (CBO) latest estimate shows that the One Big Beautiful Bill would reduce federal Medicaid spending by $793 and that the Medicaid provisions would increase the number of uninsured people by 7.8 million. Previous CBO estimates show that 10.3 million fewer people would be enrolled in Medicaid in 2034. Building on prior KFF analysis, this analysis allocates these estimated federal spending reductions and enrollment losses across the states.