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Medicaid Midterm Election Update

Midterm Election Update: Medicaid Changes

Major federal changes to Medicaid eligibility and financing from the 2025 reconciliation law are coming, including new work requirements that will affect millions of Medicaid enrollees. KFF’s fact sheet provides an overview of what has changed, what is still ahead, and what the public thinks about Medicaid heading into the midterms.

There were 72.9 million people enrolled in Medicaid/CHIP nationally in July, and enrollment declined by 5.1 million or 7% from July 2025 through July 2026.

Medicaid/CHIP Monthly Enrollment Tracker

KFF's tracker presents the most recent Medicaid monthly enrollment data. There were 72.9 million people enrolled in Medicaid/CHIP nationally in July, and enrollment declined by 5.1 million or 7% from July 2025 through July 2026.

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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  • Article and Policy Forum Examine Medicare, Health Reform and the Challenges Facing People With Disabilities

    Event Date:
    Event

    Wednesday, Sept. 8, the Foundation held a policy workshop examining Medicare, health reform and the challenges facing people with disabilities. Younger Medicare beneficiaries with disabilities are much more likely than seniors in the program to report problems accessing and paying for needed medical services, Kaiser Family Foundation researchers report in this Health Affairs article. Based on a national random-sample survey of people on Medicare, the study finds that half of nonelderly disabled beneficiaries report problems…

  • Briefing on State Medicaid Programs, the Recession and Health Reform

    Event Date:
    Event

    The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) held a 9:30 a.m. ET briefing on Thursday, September 30 to examine the challenges facing states as they continue to struggle with the lingering impacts of the recession and begin preparing to implement health reform. Three reports were released at the event: Hoping for Economic Recovery, Preparing for Reform: A Look at Medicaid Spending, Coverage and Policy Trends: Results from a 50-State Medicaid Budget…

  • Health Reform and State Workforce Challenges: An Early Look at Five States

    Report

    This report provides an early look at state efforts to prepare for health reform, examining the experiences to date in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). The report finds that the state political environment and expected leadership transitions create uncertainties and are already factoring into state strategies on health reform implementation. State leaders dealing with an aging workforce, hiring constraints, and the toll from the recession also see a need for additional…

  • Health Reform Roundtables: Charting A Course Forward

    Report

    Health Reform Roundtables: Charting A Course Forward is a series of discussions among federal officials, state officials and outside experts that provides an opportunity to share insights and explore key issues related to implementing a significant expansion of the Medicaid program as part of the new health reform law that will require most U.S. citizens and legal residents to obtain health coverage. States will be largely responsible for implementing the Medicaid expansion, which will provide…

  • Expanding Coverage to Adults through Medicaid Under Health Reform: Key Issues to Consider for Implementation

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured convened a roundtable discussion on June 23, 2010 with a group of federal and state officials and experts to discuss key issues related to reaching, enrolling and delivering care to adults in Medicaid under health reform. The discussion focused in particular on non-disabled adults without dependent children (often referred to as "childless adults") who have historically been ineligible for the program. When the new coverage goes into…

  • Care and Coverage of the Nation’s Children: A Resource Page

    Fact Sheet

    Medicaid and the Children's Health Insurance Program (CHIP) are serving as an important safety-net for children during the current recession. These programs have contributed to a decrease in the uninsured rate for children, but many eligible children remain uninsured despite the availability of Medicaid and CHIP coverage today. Provisions to strengthen coverage for children are included in both the 2009 Children’s Health Insurance Program Reauthorization Act and the Patient Protection and Affordable Care Act of…

  • Optimizing Medicaid Enrollment: Spotlight on Technology – Louisiana’s Express Lane Eligibility

    Issue Brief

    This piece looks at how Louisiana uses “express lane eligibility" to increase and streamline the enrollment of low-income children in its Medicaid program. It is the first in a Spotlight on Technology series profiling several states' innovative applications of technology to Medicaid enrollment efforts. The series illustrates a range of approaches that states can adopt to improve their systems now and to prepare for the expansion of Medicaid under health reform. Spotlight (.pdf)

  • State Medicaid Agencies Prepare for Health Care Reform While Continuing to Face Challenges from the Recession

    Issue Brief

    This report, based on discussions with leading state Medicaid directors in May 2010, examines how Medicaid agencies are preparing for a lead role in implementing health reform while continuing to deal with the impact of the recession. The report augments the most recent annual Medicaid budget survey report, released in September 2009, and a mid-year update report released in February 2010. NOTE: Updated report on fiscal years 2010 and 2011 now available. Report (.pdf)

  • Explaining Health Reform: Eligibility And Enrollment Processes For Medicaid, CHIP and Subsidies in the Exchange

    Issue Brief

    The new health reform law will require most U.S. citizens and legal residents to have health coverage by 2014. It provides new options for coverage by expanding Medicaid eligibility to more low-income people and creating a state-based system of health insurance exchanges through which individuals can purchase coverage, with federal subsidies for many. This brief and accompanying explanatory chart summarize key requirements that states face under health reform to construct coordinated and consumer-friendly enrollment systems…