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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?

Work Requirements

How Will States Implement Medicaid Work Requirements?

Event Date:

Four experts, including two state Medicaid directors, will join Health Wonk Shop moderator Larry Levitt in an hour-long discussion of how states will go about implementing new Medicaid work requirements.

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.

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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  • Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults

    Issue Brief

    This issue brief answers 3 key questions and provides new data about state medical frailty determinations, which are assuming greater importance as more states adopt restrictive Section 1115 waivers that exempt medically frail enrollees from policies such as work requirements and premiums. The findings are excerpted from our 50-state survey on Medicaid financial eligibility for seniors and people with disabilities.

  • How Connecting Justice-Involved Individuals to Medicaid Can Help Address the Opioid Epidemic

    Issue Brief

    This issue brief identifies key lessons learned from how four states (Missouri, Ohio, New Mexico, Rhode Island) are connecting people leaving the criminal justice system to Medicaid coverage and services, with a focus on medication-assisted treatment (MAT) and supports for people with opioid use disorder. It builds on previous briefs that assessed state efforts to connect people involved in the justice system to Medicaid coverage. It is based on interviews conducted in late 2018 and early 2019 with state Medicaid, behavioral health, and corrections officials in the four states and in Bernalillo County, New Mexico, as well as interviews with managed care organizations, providers, and advocates in those states and published information on the states’ experiences.

  • Medicaid Financial Eligibility for Seniors and People with Disabilities: Findings from a 50-State Survey

    Issue Brief

    This brief presents the latest information on Medicaid financial eligibility criteria and state adoption of major coverage pathways related to old age and disability. The findings are based on a survey of the 50 states and the District of Columbia that asked questions related to financial eligibility and policy choices related to mandatory and optional eligibility pathways. The brief also analyzes the likelihood of adopting optional pathways given a state’s ACA expansion status.

  • Abismo en el financiamiento de Medicaid: Implicaciones para los sistemas de atención de salud de Puerto Rico y las Islas Vírgenes de los EE.UU.

    Issue Brief

    Este resumen ofrece una descripción general del estado de los sistemas de atención médica y los programas de Medicaid en Puerto Rico y las Islas Vírgenes de los EE.UU. (USVI) aproximadamente un año y medio después que los huracanes Irma y María azotaran las islas, en septiembre de 2017. Después de las tormentas, los programas de Medicaid de los territorios han servido como recursos importantes para atender las necesidades de atención médica de los residentes, pero han operado bajo desafíos financieros de larga data. Este resumen se enfoca en esos desafíos e incluye el análisis de KFF de las consecuencias para las finanzas de los programas de Medicaid de los territorios, ya que la mayoría de los fondos federales de Medicaid provistos a través de la Ley de Cuidado de Salud a Bajo Precio (ACA), y la asistencia para desastres, expirarán a fines de septiembre de 2019. Los otros territorios de los EE.UU. (Samoa Americana, el Commonwealth de las Islas Marianas del Norte y Guam) también enfrentan retos relacionados con el vencimiento programado de los fondos de ACA. Este resumen se basa en trabajos anteriores y en informes públicos recientes, y en entrevistas con funcionarios de los territorios en los lugares afectados, con proveedores, con responsables de planes de salud de Puerto Rico y beneficiarios.

  • How Do Medicaid/CHIP Children with Special Health Care Needs Differ from Those with Private Insurance?

    Issue Brief

    This issue brief compares the demographics, health status, access to care, and coverage affordability of Medicaid/CHIP children with special health care needs to those with private insurance and those who are uninsured. Medicaid plays a key role for children with special health care needs by making coverage affordable and covering services that private coverage typically does not. Consequently, legislative proposals that would cap and reduce federal Medicaid funding may pose a particular risk to children with special health care needs and their providers. A companion brief describes Medicaid’s role for children with special health care needs.

  • Medicaid’s Role for Children with Special Health Care Needs: A Look at Eligibility, Services, and Spending

    Issue Brief

    This issue brief describes the role that Medicaid plays for children with special health care needs. It explains common eligibility pathways, covered services, and program spending for these children. The Appendix includes 50-state data on the number of children with special health care needs covered by Medicaid/CHIP. A companion brief compares key characteristics of Medicaid/CHIP children with special health care needs to those covered by private insurance.

  • Disability and Technical Issues Were Key Barriers to Meeting Arkansas’ Medicaid Work and Reporting Requirements in 2018

    Issue Brief

    This issue brief analyzes the impact of the four measures intended to safeguard coverage for people with disabilities and others who should not have been subject to the work and reporting requirements. It draws on data newly available from Arkansas’ 2018 annual waiver report to CMS and monthly data released by the state while the requirements were in effect. The data reveal that few people used these safeguard measures relative to the number of people who lost coverage due to the new requirements. Among those who accessed the safeguards, the vast majority did so due to disability/other health issues or technical issues such as those related to reporting.

  • The Opioid Epidemic and Medicaid’s Role in Facilitating Access to Treatment

    Issue Brief

    This brief describes nonelderly adults with opioid use disorder, including their demographic characteristics and insurance status, and compares utilization of treatment services among those with Medicaid to those with other types of coverage. It also describes Medicaid financing for opioid treatment and the ways in which Medicaid promotes access to treatment for enrollees with OUD.