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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.

The Essentials

  • 5 Facts: Medicaid and Provider Taxes

    This brief describe states’ current provider taxes and how the 2025 reconciliation law changed the federal rules governing them, including potential impacts across states.

  • 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: 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.

  • 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.
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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  • 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.

  • Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19

    Issue Brief

    Recent federal legislation, the Families First Coronavirus Response Act, amended by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, authorizes a 6.2 percentage point increase in federal Medicaid matching funds to help states respond to the COVID-19 pandemic. This issue brief answers key questions about the new federal funds, drawing on two sets of frequently asked questions about the Families First Coronavirus Response Act and CARES Act issued by the Centers for Medicare and Medicaid Services (CMS).

  • The Relationship Between Work and Health: Findings from a Literature Review

    Issue Brief

    A central question in the current debate over work requirements in Medicaid is whether such policies promote health and are therefore within the goals of the Medicaid program. This brief examines literature on the relationship between work and health and analyzes the implications of this research in the context of Medicaid work requirements.

  • KFF/EHF Poll: Texans’ Top State Health Priorities Include Lowering Out-of-Pocket Costs and Reducing Maternal Mortality

    News Release

    Most Texans Don’t Know their State has the Nation’s Highest Uninsured Rate Texans’ top health care priorities for the state revolve around making health care and prescription drugs more affordable, reducing maternal mortality and increasing access to health insurance coverage, finds a new statewide Kaiser Family Foundation/Episcopal Health Foundation survey on Texas health policy issues.

  • Texas Residents’ Views on State and National Health Policy Priorities

    Report

    As part of the new Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texans’ views on health policy priorities at both the state and national level. It examines how Texas residents view state spending on health care and how they rank initiatives such as lowering health care costs, reducing maternal mortality, and funding for mental health care. It also explores Texans’ views on the Affordable Care Act and Medicaid, including personal connections to the Medicaid program and support for Medicaid expansion.

  • 33 States and DC Have Adopted Medicaid Expansion, as of May 2018

    Feature

    Source Current status for each state is based on KFF tracking and analysis of state executive activity. Also see the related State Health Facts page “Status of State Action on the Medicaid Expansion Decision” for additional details.

  • Atención de salud en Puerto Rico y las Islas Vírgenes de los Estados Unidos: una revisión, a seis meses de las tormentas (Informe)

    Issue Brief

    Puerto Rico y las Islas Vírgenes de los Estados Unidos (USVI) sufrieron daños significativos en su infraestructura y sistemas de salud a causa del impacto de los huracanes Irma y María en septiembre de 2017. Basándose en entrevistas con residentes, partes interesadas clave, y en informes públicos, este informe proporciona una visión general del estado de los esfuerzos de recuperación, a seis meses de las tormentas, con un enfoque en los sistemas de atención médica.

  • Nearly 20 Million Children Live in Immigrant Families that Could Be Affected by Evolving Immigration Policies

    Issue Brief

    President Trump has intensified national debate about immigration by implementing policies to enhance immigration enforcement and restrict legal immigration. Recent findings show that the climate surrounding these policies has significantly increased fear and uncertainty among immigrant families, broadly affecting families across different immigration statuses and locations. The effects extend to lawfully present immigrants, including lawful permanent residents or “green card” holders, and children in immigrant families, who are predominantly U.S.-born citizens. In particular, findings point to both short- and long-term negative consequences on the health and well-being of children in immigrant families.
    Potential changes to public charge policies intended to reduce use of public programs by immigrant families, including their citizen children, could further increase strains on immigrant families and lead to losses in health coverage. To provide insight into the scope of potential impacts of continually evolving immigration policy on children, this data note provides nationwide and state-level estimates (Table 1) of citizen children living in immigrant families and the number currently covered by Medicaid/CHIP coverage.