KFF October 31, 2025
On July 4, President Trump signed into law a budget and tax bill that includes significant changes to the Medicaid program including new requirements for states to implement work requirements for individuals enrolled through the Affordable Care Act (ACA) Medicaid expansion pathway or certain state waivers. The Congressional Budget Office (CBO) estimates that this requirement will have the largest effect on spending and coverage compared to other provisions, reducing federal Medicaid spending by $326 billion over ten years and resulting in 5.3 million more people who are uninsured.
In the summer of 2025 while the new law was under debate in Congress and shortly after enactment, the 25th annual budget survey of Medicaid officials in all 50 states and the...
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