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How Will the 2025 Reconciliation Bill Affect the Uninsured Rate in Each State? Allocating CBO’s Estimates of Coverage Loss | KFF
House Republicans have passed a reconciliation package (the “One Big Beautiful Bill Act”) that would make significant changes to Medicaid and the Affordable Care Act (ACA) Marketplaces and increase the number of people without health insurance by an estimated 10.9 million. This analysis estimates state-level increases in the number of uninsured people due to this legislation, along with other changes to the Marketplace, including the expiration of the enhanced premium tax credits.
KFF Health Tracking Poll: The Public's Views of Funding Reductions to Medicaid | KFF
As Congress works to pass the "One Big Beautiful Bill Act," which includes significant changes to Medicaid and the ACA, the latest KFF Health Tracking Poll examines the views of groups that could be most directly impacted by the impending legislation. The poll finds most of the public is worried about the consequences of federal funding reductions to Medicaid, including rural residents, those with lower incomes, and across partisans.
Make American Health Care Affordable Again | KFF
In this JAMA Health Forum column, Larry Levitt highlights how the Make America Healthy Again agenda aimed at chronic disease does little to address the affordability of health care and that efforts to lower federal spending on health care may worsen the problem, raising out-of-pocket costs for many people with Medicaid and Affordable Care Act<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/health-costs/perspective/make-american-health-care-affordable-again/" class="see-more light-beige no-float inline-readmore">More</a></p>
More Than Half of the Public Worries Federal Medicaid Budget Cuts Would Affect Their Family’s Ability to Obtain and Afford Care; More Worry It Will Increase the Uninsured | KFF
As Congress weighs spending cuts and other changes to Medicaid, more than half (54%) of the public say they are worried significant reductions in federal Medicaid spending would negatively affect their family’s ability to obtain and afford health care, a new KFF Health Tracking Poll finds. This includes about three in 10 (29%) who say<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/affordable-care-act/press-release/more-than-half-of-the-public-worries-federal-medicaid-budget-cuts-would-affect-their-familys-ability-to-obtain-and-afford-care-more-worry-it-will-increase-the-uninsured/" class="see-more light-beige no-float inline-readmore">More</a></p>
Federal Vaccine Advisory Committees: Roles and Current Issues | KFF
This brief describes four key federal vaccine advisory committees and discusses policy issues and questions they currently face. The four committees are the Vaccines and Related Biological Products Advisory Committee (VRBPAC) at the Food and Drug Administration (FDA); the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC); the National Vaccine Advisory Committee (NVAC) at the Department of Health and Human Services (HHS); and the Advisory Commission on Childhood Vaccines (ACCV) at HHS.
Administration Releases Additional Details of Fiscal Year 2026 Budget Request | KFF
On May 30, 2025, the administration released additional details of its Fiscal Year 2026 budget request, including more specific information on funding for global health activities at the State Department, U.S. Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH). The proposed budget includes significant<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/global-health-policy/fact-sheet/administration-releases-additional-details-of-fiscal-year-2026-budget-request/" class="see-more light-beige no-float inline-readmore">More</a></p>
Which Federal Agencies Make Medicare Work and How Were They Affected by Recent Changes Made by the Trump Administration? | KFF
This brief highlights some of the key federal agencies and offices that play a role in making Medicare work and, to the extent possible, describes the recent staffing and organizational changes made by the Trump administration that could affect the operations of Medicare in the future.
Early Indications of the Impact of the Enhanced Premium Tax Credit Expiration on 2026 Marketplace Premiums | KFF
Every summer, health insurers submit rate filings to state regulators detailing expectations and justifying premium rate changes for ACA-regulated health plans for the coming year. With the enhanced premium tax credits set to expire at the end of 2025, consumers can expect increases in how much they pay for coverage. KFF examines 23 early insurer<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/affordable-care-act/issue-brief/early-indications-of-the-impact-of-the-enhanced-premium-tax-credit-expiration-on-2026-marketplace-premiums/" class="see-more light-beige no-float inline-readmore">More</a></p>
June 11 Virtual Event: How the Trump Administration and Congress Are Reshaping the Affordable Care Act's Marketplaces: Views from the States | KFF
Through regulations and the House budget reconciliation bill, significant changes are being considered by Congress and the Trump Administration for how the Affordable Care Act’s health insurance Marketplaces would work. At the same time, the enhanced tax credits that have made Marketplace coverage more affordable and driven record enrollment are set to expire at the<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/affordable-care-act/event/june-11-virtual-event-how-the-trump-administration-and-congress-are-reshaping-the-affordable-care-acts-marketplaces-views-from-the-states/" class="see-more light-beige no-float inline-readmore">More</a></p>
What to Know About the Older Americans Act and the Services it Provides to Older Adults | KFF
The Trump administration is proposing a reorganization and staffing cuts at HHS that create uncertainty about the potential effects on older adults, who receive services authorized under the Older Americans Act. This brief provides an overview of programs and services provided under the Older Americans Act, the role played by the Administration for Community Living in administering these programs, and trends in program funding and service utilization by older adults.
Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces | KFF
The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.
The Performance of the Federal Independent Dispute Resolution Process through Mid-2024 | KFF
The No Surprises Act, which was signed into law by President Trump during his first term and took effect in 2022, aims to protect consumers from certain surprise medical bills. The law established processes to keep the patient out of the payment negotiations between the provider and the plan. In the event of an unsuccessful<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/health-costs/issue-brief/the-performance-of-the-federal-independent-dispute-resolution-process-through-mid-2024/" class="see-more light-beige no-float inline-readmore">More</a></p>
Allocating CBO’s Estimates of Federal Medicaid Spending Reductions and Enrollment Loss Across the States | KFF
The Congressional Budget Office’s (CBO) latest cost estimate shows that the One Big Beautiful Bill would reduce federal Medicaid spending by $723 billion, with an estimated Medicaid enrollment loss of 10.3 million people in 2034. Building on prior KFF analysis, this analysis allocates these estimated federal spending reductions and enrollment losses across the states.
Expansions to Health Savings Accounts in House Budget Reconciliation: Unpacking the Provisions and Costs to Taxpayers | KFF
The House budget reconciliation bill contains various expansions to Health Savings Accounts (HSAs). This policy watch explains what HSAs are, how they have been used, what the key changes to HSAs would be, and how much they would cost the federal government.
5 Key Facts About Nursing Facilities and Medicaid | KFF
The substantial Medicaid savings in the reconciliation bill that has been passed by the House could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them. Nursing facilities provide medical and personal care services for older adults and people with disabilities, and Medicaid covered 44% of long-term institutional care costs in 2023.
Utilization of Health Care Services by Medicaid Expansion Status | KFF
Some critics of Medicaid expansion have argued that expansion diverts resources away from other groups of Medicaid enrollees, including people with disabilities and children, and that expansion enrollees are “able-bodied” implying they have minimal health care needs. However, data show that expansion states spend more per enrollee overall and on each eligibility group than non-expansion states and that nearly half of expansion enrollees have a chronic condition. This data note analyzes 2021 Medicaid claims data to compare utilization of health care services among Medicaid expansion enrollees with other Medicaid enrollees in expansion states and to compare utilization of health care services among adult Medicaid enrollees living in expansion and non-expansion states.
New Vaccine Requirements, Anti-mRNA Narratives, and Disputed Gender-Affirming Care Report — The Monitor | KFF
This volume highlights how new vaccine requirements and the spread of anti-mRNA sentiments are fueling confusion and distrust. It also examines reactions to a federal report on gender-affirming care for minors and investigates how TikTok is being used to promote false health claims through deepfake personas targeting young women.
Proposed Medicaid Federal Match Penalty for States that Have Expanded Coverage for Immigrants: State-by-State Estimates | KFF
This analysis examines the potential impacts of a provision in the House reconciliation bill that proposes reducing the federal matching rate for the Affordable Care Act (ACA) Medicaid expansion population from 90% to 80% for states that either provide health coverage or financial assistance to purchase health coverage to individuals who are not “a qualified alien.”
Mapping Hospital Employment By State | KFF
Changes to Medicaid funding, eligibility and enrollment could impact hospital finances. These interactive 50-state maps show the number of hospital employees by state and how hospital employment ranks among industry subsectors. Hospitals employed 6.7 million people in 2023, and more than 100,000 people in each of 23 states.
Tracking the Affordable Care Act Provisions in the 2025 Reconciliation Bill | KFF
KFF is tracking the Medicaid provisions in the 2025 federal budget bill, including new Medicaid work and verification requirements and a reduction in the expansion match rate for states that use their own funds to cover undocumented immigrants.
State Profiles for Dual-Eligible Individuals
This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries). Dual-eligible individuals qualify for Medicare coverage on the basis of age (65 and older) or disability. To qualify for Medicaid benefits, Medicare beneficiaries must meet eligibility criteria based on financial (related to income and wealth) and non-financial (generally, age or disability) requirements. For “partial-benefit” enrollees, Medicaid pays Medicare premiums and, in many cases, also pays Medicare’s deductibles and cost-sharing on behalf of dual-eligible individuals. Dual-eligible individuals who also receive the full range of Medicaid benefits that are not covered by Medicare are generally referred to as “full-benefit” enrollees. This data collection includes the number of dual-eligible individuals and Medicare and Medicaid spending on these enrollees.<br><br>This work was supported in part by Arnold Ventures. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.
Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience | KFF
On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.
Amid Increased Immigration Enforcement, a Majority of Lawfully Present Immigrants Are Worried They or a Family Member Could Be Detained or Deported | KFF
A new KFF poll of immigrants finds that six in 10 lawfully present immigrants say they worry about the possibility that they or a family member could be detained or deported, contributing to feelings of increased stress, anxiety, and other health problems. The increased fears come against a backdrop of more restrictive federal immigration policies<span class="readmore-ellipsis">…</span><a href="https://www.kff.org/other/press-release/amid-increased-immigration-enforcement-a-majority-of-lawfully-present-immigrants-are-worried-they-or-a-family-member-could-be-detained-or-deported/" class="see-more light-beige no-float inline-readmore">More</a></p>
How Will the 2025 Reconciliation Bill Affect the Uninsured Rate in Each State?: Allocating CBO’s Partial Estimates of Coverage Loss | KFF
Legislation passed by the Energy and Commerce Committee could increase the number of people without health insurance by 8.6 million, due largely to changes to Medicaid and the ACA. Combining the provisions with the effect of the expected expiration of the ACA’s enhanced premium tax credits, CBO expects 13.7 million more people will be uninsured in 2034.
Proposed Medicaid Federal Match Penalty for States that Cover Undocumented Immigrants with Their Own Funds: State-by-State Estimates | KFF
This analysis examines the potential impacts of a provision in the House reconciliation bill that proposes reducing the federal matching rate for the Affordable Care Act (ACA) Medicaid expansion population from 90% to 80% for states that either provide health coverage or financial assistance to purchase health coverage to individuals who are not lawfully residing in the United States.
Marketplace Enrollees with Unpredictable Incomes Could Face Bigger Penalties Under House Reconciliation Bill Provision | KFF
This analysis illustrates how provisions included in the House budget reconciliation bill could expose Marketplace enrollees with unpredictable incomes to higher penalties when filing taxes if they underestimate their incomes. About one in four potential Marketplace shoppers had incomes that varied at least 20 percent from the beginning to the end of the year.
State-Level Context for Federal Medicaid Cuts of $625 Billion and Enrollment Declines of 10.3 Million | KFF
Based on draft reconciliation language from the Energy & Commerce Committee, the Congressional Budget Office (CBO) released preliminary estimates showing proposed Medicaid changes would reduce federal Medicaid spending by $625 billion. Building on earlier KFF analysis, this analysis puts this magnitude of federal funding cuts into context by showing how the cuts relate to states’ budgets and exploring the potential effects on Medicaid enrollment by state.