Medicaid Roundup: Recapping the Medicaid Provisions in the 2025 Federal Reconciliation Bill

The latest from KFF on the proposed Medicaid changes and how they could interact with other possible policy changes.

View in browser The Senate will return next week to begin considering the "big, beautiful bill" that narrowly passed the House, which included significant changes to Medicaid, the Affordable Care Act (ACA), as well as additional provisions related to Medicare and Health Savings Accounts. What's in the bill and what's ahead? Read the latest from KFF on the proposed Medicaid changes and how they could interact with other possible policy changes, like the expiration of the enhanced premium tax credits, to affect state spending on and access to health care for millions of Americans.  Featured 2025 Reconciliation Bill: Tracking Medicaid and Other Health Provisions   What was included in the final House budget reconciliation bill passed on May 22? Check out KFF's tracker to learn about the proposed cuts to Medicaid and the ACA, as well as what these changes could mean for expansion, eligibility, care access, financing, and more. Data: State Medicaid Fact Sheets   State Medicaid programs vary as states have some flexibility in determining whom to serve, what care to cover, and how to deliver and reimburse for care, including determining eligibility limits and coverage levels.  Drew Altman's Beyond the Data Columns on Medicaid and the ACA   In recent columns, KFF's President and CEO Drew Altman explains how proposals contained in the House reconciliation bill could result in a one-third reduction in Marketplace enrollment and discusses the history of the battles over the ACA's provisions that were designed to expand coverage for the uninsured, which helps explain the effort to cut federal funding for the Medicaid expansion today.  Timely insights and analysis from KFF staff House Bill Would Penalize More States for Covering Immigrants, Including Lawfully Residing Children and Pregnant People A revision made to the bill before it was considered by the Rules committee expanded the penalty from 14 states and DC that cover undocumented immigrants with state funds to 33 states and DC that use a federal option available in Medicaid and/or CHIP to expand coverage for lawfully residing children and/or pregnant people. Opioid Deaths Are Falling, Though Proposed Medicaid Changes Could Disrupt Access to Treatment Recent federal proposals may affect Medicaid coverage and treatment access at a time when opioid deaths are declining, but future trends are uncertain. Medicaid plays a large part in responding to the opioid epidemic. Medicaid is the primary source of coverage for adults with opioid use disorder.  Policy Research Implementing Work Requirements on a National Scale: What We Know from State Waiver Experience Preliminary estimates released by the Congressional Budget Office (CBO) show that the Medicaid work requirement provisions in the House-passed budget reconciliation bill 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.   Implications of Potential Federal Medicaid Reductions for Addressing the Opioid Epidemic Medicaid is the main source of coverage for adults with opioid use disorder and among those receiving treatment services. Most adults with opioid use disorder (OUD) in Medicaid are eligible through Medicaid expansion. The House bill proposes a number of provisions that could affect Medicaid eligibility and coverage stability for adults with OUD including work requirements and increased eligibility determinations.      How Will the 2025 Reconciliation Bill Affect the Uninsured Rate in Each State?: Allocating CBO's Partial Estimates of Coverage Loss 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.   Utilization of Health Care Services by Medicaid Expansion Status 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.   5 Key Facts About Nursing Facilities and Medicaid 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.     5 Key Facts About Medicaid and Family Planning Amid debates about reducing federal spending on Medicaid, this brief presents five facts about the program's role in providing access to contraception and other family planning care for low-income individuals.    5 Key Facts About Medicaid and Pregnancy This brief examines Medicaid's pregnancy and postpartum coverage and its role in strengthening and improving maternal health outcomes.   Major Federal and State Funding Cuts Facing Planned Parenthood There are currently multiple efforts at the federal and state level to limit funding to Planned Parenthood, including through Medicaid. According to KFF's Health Tracking Poll, the majority of Medicaid beneficiaries who received family planning services at a planned parenthood clinic received contraceptive services and care for a sexually transmitted infection.   Mapping Hospital Data Hospitals employed 6.7 million people in 2023, and more than 100,000 people in each of 23 states. Changes to Medicaid funding, eligibility and enrollment could impact hospital finances. The Mapping Hospitals by Congressional District interactive map shows the number of hospitals in each congressional district, and the Mapping Hospital Employment by State interactive maps show the number of hospital employees by state and how hospital employment ranks among industry subsectors.   Visit Medicaid Watch for the latest on the financing debate, including possible impacts on state budgets, debates about waste, fraud, abuse, and improper payments, considerations of work requirements, and news stories about legislative developments and how people may be affected. Polling 7 Charts About Public Opinion on Medicaid This data note provides an overview of KFF polling on the public's views of and connections to Medicaid, the federal-state government health insurance for certain low-income adults and children and long-term care program for adults 65 and older and younger adults with disabilities. Health News Republicans Aim To Punish States That Insure Unauthorized Immigrants A GOP tax-and-spending bill the House approved Thursday would slash federal Medicaid reimbursement for states that offer health coverage to immigrants without legal status. (KFF Health News)  In Arizona County That Backed Trump, Conflicted Feelings About Cutting Medicaid Medicaid plays a vital role in many rural communities that favored President Donald Trump in the 2024 election. But residents still seem open to Republican proposals to cut perceived waste in the program. (KFF Health News)    'What the Health?': Bill With Billions in Health Program Cuts Passes House The House narrowly passed a budget reconciliation bill, including billions of dollars in tax cuts for the wealthy along with billions of dollars in cuts to health program spending. But the Senate is expected to make major changes to the measure before it can go to President Donald Trump for his signature. (KFF Health News)   How Trump Aims To Slash Federal Support for Research, Public Health, and Medicaid One thing experts agree on: The damage from the funding cuts will be varied and immense. (KFF Health News)    Housing, Nutrition in Peril as Trump Pulls Back Medicaid Social Services About half of states have broadened Medicaid, the state-federal low-income health care program, to pay for social services such as housing and nutritional support. The Trump administration, however, views these experiments as distractions from the core mission to provide health care. (KFF Health News)    Californians Receiving In-Home Care Fear Medicaid Cuts Will Spell End to Independent Living Bay Area senior Carol Crooks doesn't know where congressional Republicans will land on Medicaid cuts as they look to fund a tax bill, but her health has already deteriorated as she worries about losing the help she needs to remain in her Oakland apartment — and out of a nursing home. (KFF Health News)    Medicaid Payments Barely Keep Hospital Mental Health Units Afloat. Federal Cuts Could Sink Them. Patients seeking mental health care are more likely to be on Medicaid than patients in more profitable areas of care, such as cancer or cardiac treatment. (KFF Health News)  Did someone forward this to you? Subscribe to KFF emails. This email was sent to awesomeblogger71.lificletter@blogger.com. Update your email preferences to choose the types of emails you receive. Or, permanently unsubscribe from all future emails. Need assistance? Email subscriptions@kff.org; do not reply to this email. The independent source for health policy research, polling, and news. KFF, 185 Berry Street, Suite 2000, San Francisco, CA 94107