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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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  • Poll: Nearly Half of the Public Say They or a Family Member Skipped or Delayed Care Due to Coronavirus, But Most Plan to Get Care in the Coming Months

    News Release

    Nearly One in Four Expect a Family Member to Turn to Medicaid in the Coming Year, and Majorities across Party Lines Oppose Medicaid Cuts to Address State Budget Shortfalls Amid the threat of coronavirus, nearly half (48%) of Americans say someone in their family has skipped or delayed getting some type of medical care due to the pandemic, the latest KFF Health Tracking Poll finds. This includes 11% who say the person’s condition worsened due…

  • State Actions to Facilitate Access to Medicaid and CHIP Coverage in Response to COVID-19

    Issue Brief

    This brief summarizes state changes to Medicaid and CHIP eligibility and enrollment policies in response to the COVID-19 outbreak, beyond those required to access enhanced federal funding. It is based on KFF analysis of approved Medicaid and CHIP state plan amendments (SPAs) and information on state websites as of May 21, 2020.

  • Impact of Coronavirus on Community Health Centers

    Issue Brief

    Community health centers are a national network of safety net primary care providers that fill an important role in national, state, and local responses to the coronavirus pandemic. This brief presents findings from new data that provide insights into how health centers are adapting their services in response to the pandemic and how coronavirus is affecting their operations and long-term financial outlook with patient visits and revenue from those visits dropping precipitously.

  • As People Lose Jobs Due to the Coronavirus Crisis and Enroll in Medicaid, Survey Finds States Anticipate Medicaid Budget Shortfalls

    News Release

    Many states that shared budget projections in response to a new KFF survey of state Medicaid officials report that they expect to see Medicaid budget shortfalls due to rising Medicaid spending and enrollment as people lose jobs amid the coronavirus pandemic and more people enroll in the government health insurance program for low-income people. KFF conducted the rapid survey of Medicaid directors in all 50 states and the District of Columbia with Health Management Associates…

  • Early Look at Medicaid Spending and Enrollment Trends Amid COVID-19

    Issue Brief

    The coronavirus pandemic has generated both a public health crisis and an economic crisis, with major implications for Medicaid, a countercyclical program. During economic downturns, more people enroll in Medicaid, increasing program spending at the same time state tax revenues may be falling. To help support states as enrollment in Medicaid grows and ensure existing enrollees maintain continuous coverage, the Families First Coronavirus Response Act (FFCRA) authorized a 6.2 percentage point increase in the federal…

  • As Unemployment Skyrockets, KFF Estimates More than 20 Million People Losing Job-Based Health Coverage Will Become Eligible for ACA Coverage through Medicaid or Marketplace Tax Credits

    News Release

    Coverage Losses Will Affect At Least a Million Residents in Each of Eight States: California, Texas, Pennsylvania, New York, Georgia, Florida, Michigan and Ohio With more than 31 million workers filing unemployment claims between March 1 and May 2 as the coronavirus crisis hit the nation’s economy, a new KFF analysis estimates 26.8 million people across the country would become uninsured due to loss of job-based health coverage if they don't sign up for other…

  • Eligibility for ACA Health Coverage Following Job Loss

    Issue Brief

    As unemployment claims skyrocket amid the coronavirus (COVID-19) crisis, this analysis examines the potential loss of job-based coverage among people in families where someone lost employment between March 1 and May 2 and estimate their eligibility for ACA coverage as of May and January 2021, when most will have exhausted their unemployment benefits.

  • How Can Lessons from Medicaid Help Connect People to Unemployment Insurance?

    Issue Brief

    Millions of people are losing jobs due to the coronavirus pandemic and seeking financial assistance through Unemployment Insurance (UI) programs. While UI can provide an important source of temporary assistance for many people losing jobs, there have been reports of major challenges accessing UI benefits. Over time, states have significantly streamlined Medicaid and the Children’s Health Insurance Program (CHIP) application and enrollment processes to overcome many similar challenges to connect eligible people to health insurance…