At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits Authors: Scott Hulver, Alice Burns, Jessica Mathers, and Robin Rudowitz Published: Aug 14, 2026

https://www.kff.org/medicaid/at-least-37-states-have-medicaid-state-directed-payments-for-hospital-services-that-could-be-reduced-by-the-2025-reconciliation-law-limits/ This analysis estimates the number of states impacted by and the amount of current federal spending on Medicaid state directed payments for hospital services that exceeds the new limits established by the 2025 reconciliation law when fully implemented.