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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

The Impact of H.R. 1 on Two Medicaid Eligibility Rules

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?

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.

The Essentials

  • 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.

  • 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: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 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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  • Obamacare y Usted: Si tiene bajos ingresos y puede calificar para Medicaid

    Fact Sheet

    Obamacare crea muchas formas de obtener cobertura de salud. Usted puede aprender sobre sus opciones llenando una única aplicación. Así, se le dirá si califica para cobertura gratis o a bajo costo a través del programa Medicaid, o a través de los nuevos Mercados de Seguros Médicos que han sido establecidos en cada estado.

  • Key Findings from the Field: Early Experience with ACA Enrollment in Maryland and Nevada

    Issue Brief

    To learn more about the early ACA enrollment experience in two states, the Kaiser Commission on Medicaid and the Uninsured and PerryUndem Research and Communication conducted focus groups in Baltimore, Maryland and Reno, Nevada in November 2013 with low- and moderate-income individuals who recently applied for health insurance and consumer assisters trained to help individuals enroll. This study builds on previous work that examined preparations for open enrollment in several states, including Maryland and Nevada, which are both moving forward with the ACA’s Medicaid expansion to low-income adults and have established their own State-based Marketplace (SBM). The focus group discussions included adults who had successfully applied as well as consumer assisters.This brief provides key findings about the early ACA enrollment experience in Baltimore, Maryland and Reno, Nevada based on focus group discussions with these recent applicants and enrollment assisters.

  • Improving the Financial Accountability of Nursing Facilities

    Report

    This report examines nursing facility expenditures to assess relative spending increases in areas such as nursing services, administrative costs, and profits. Using California as a case study, it explores reimbursement by cost category and a standard medical loss ratio (MLR) as potential policy options to improve nursing facility financial accountability and care quality.

  • Understanding the Intersection of Medicaid and Work: An Update

    Issue Brief

    Amid renewed interest in Medicaid work requirements as part of a broader legislative package designed to significantly reduce federal Medicaid spending, KFF has updated its analysis of the work status and demographic characteristics of Medicaid enrollees with the latest data.

    Data show that, in 2023, 92% of Medicaid adults were either working full or part-time (64%), or were not working due to barriers to work such as caregiving responsibilities, illness or disability, or school attendance -- reasons that counted as qualifying exemptions from the work requirements under previous policies.

  • Kindergarten Routine Vaccination Rates Continue to Decline

    Issue Brief

    This issue brief provides an update on the latest trends in kindergarten children's routine vaccination and exemption rates. Over three-quarters (39) of states had measles, mumps, rubella (MMR)vaccination rates below the “target” rate of 95% for the 2024-2025 school year.

  • 5 Key Facts About Medicaid and Hospitals

    Issue Brief

    We explain 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.