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2025 Reconciliation Law

How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?

This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10 million in 2034. That number would rise to over 14 million if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.

ANALYSIS

Allocating Federal Medicaid Spending Reductions Across States

Policy Tracker

Medicaid Provisions in the 2025 Budget Reconciliation Law

ANALYSIS

How Might Federal Medicaid Cuts Affect Rural Areas?

From Drew Altman

Can Democrats Make Medicaid and ACA Cuts Their Winning Political Issue?

The Essentials

  • 5 Facts: Medicaid and Provider Taxes

    As Congress weighs potential cuts in federal Medicaid spending, one option under consideration is to limit the use of state taxes on providers. This brief describe states’ current provider taxes and the federal rules governing them.

  • 5 Facts: Medicaid Work Requirements

    This brief highlights five key facts about Medicaid work requirements, including the share of Medicaid enrollees who currently work, what research shows about the impact of work requirements, and the administrative burdens associated with implementing them.

  • Implementing National Work Requirements

    Federal Medicaid work requirements raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.

  • Medicaid Financing: The Basics

    Medicaid represents $1 out of $6 spent on health care in the U.S. and is the major source of financing for state health coverage and long-term services and supports for low-income residents.
     

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.

  • Adults with Mental Illness

    Options under consideration in Congress to significantly reduce Medicaid spending could have major implications for adults who live with mental illness.

  • 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.

key facts about medicaid

  • 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 Family Planning

    As the largest public payer for family planning services in the US, changes to Medicaid could have a large impact on access to contraception and other family planning care for low-income individuals.

  • 5 Facts: Medicaid for People 50 and Older

    The budget reconciliation bill that includes significant changes to the Medicaid program. Many of the reductions in coverage will be among the 22 million Medicaid enrollees ages 50 and older.

  • 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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  • Nursing Facility Staff Vaccinations, Boosters, and Shortages After Vaccination Deadlines Passed

    Issue Brief

    This analysis uses nursing facility-level data reported by the federal government to track the increase in vaccination rates among nursing facility staff nationally and by state between August 2021 (when the vaccine mandate was first announced) and March 27th, 2022 (after the vaccine deadline for health workers had passed in all states). Additionally, this analysis provides state-level information on booster rates among nursing home staff and the prevalence of staffing shortages after all vaccination deadlines had passed.

  • State Actions to Address Nursing Home Staffing During COVID-19

    Issue Brief

    This issue brief summarizes federal and state standards related to nursing home staffing prior to COVID-19 and builds on existing information by identifying changes to state minimum staffing requirements adopted since the onset of the COVID-19 pandemic. We also examine state legislative and regulatory actions since the onset of the pandemic that directly affect worker wages and training requirements.

  • Unwinding the PHE: What We Can Learn From Pre-Pandemic Enrollment Patterns

    Issue Brief

    This brief examines typical enrollment patterns for Medicaid and CHIP and uses 2018 Medicaid claims data to gain insight into the effects of the continuous enrollment requirements by eligibility group. Roughly 2% of Medicaid enrollees come on or leave the program in an average month, although there is variation across eligibility groups. A policy to require continuous enrollment would result in sharp reductions in monthly disenrollment rates and would also reduce monthly enrollment rates due to reductions in churn.

  • An Overview of Medicaid Work Requirements: What Happened Under the Trump and Biden Administrations?

    Issue Brief

    The Trump Administration aimed to reshape the Medicaid program by newly approving Section 1115 demonstration waivers that imposed work and reporting requirements as a condition of Medicaid eligibility. However, courts struck down many of these approvals and the Supreme Court recently dismissed pending challenges in these cases. Available implementation data suggests that work requirements were confusing to enrollees and result in substantial coverage loss, including among eligible individuals.

  • Medicaid Administrative Data: Challenges with Race, Ethnicity, and Other Demographic Variables

    Issue Brief

    There are persistent disparities in health and health care for people of color, which reflect structural and systemic inequities rooted in racism and discrimination. High-quality comprehensive data are key to enabling policymakers, community leaders, and other key stakeholders to identify and address these inequities and measure progress over time. Medicaid/CHIP administrative data, also known as Transformed Medicaid Statistical Information System (T-MSIS) or TAF (T-MSIS Analytic File), hold the potential to inform disparities research through detailed demographic, service utilization, and spending data of Medicaid and CHIP beneficiaries —but there are current limitations.

  • Help with Medicare Premium and Cost-Sharing Assistance Varies by State

    Issue Brief

    This data note provides an overview of programs that help beneficiaries with modest incomes with their Medicare costs, including the Medicare Savings Programs and the Part D Low-Income Subsidy, and highlights findings from corresponding state-level profiles of eligibility and enrollment.