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 +++

At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits Aug 14, 2026 Issue Brief 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. 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/ Optional Medicaid and CHIP Coverage for Lawfully Present Immigrant Children Could Mitigate Coverage Losses Due to 2025 Reconciliation Law Aug 14, 2026 Issue Brief This brief provides an overview of health coverage of noncitizen children to provide greater insight into the potential role of Immigrant Children’s Health Improvement Act (ICHIA) coverage in limiting the 2025 reconciliation law's impact on coverage for lawfully present immigrant children. https://www.kff.org/racial-equity-and-health-policy/optional-medicaid-and-chip-coverage-for-lawfully-present-immigrant-children-could-mitigate-coverage-losses-due-to-2025-reconciliation-law/ New Regulation Prohibits Federal Medicaid Funds From Covering Gender-Affirming Medical Care for Young People Aug 13, 2026 Quick Insights If states do not provide coverage with state-only dollars and [gender-affirming] care cannot be financed in other ways, thousands of young people could be without a way to access what remains a recommended medical intervention. https://www.kff.org/quick-insights/new-regulation-prohibits-federal-medicaid-funds-from-covering-gender-affirming-medical-care-for-young-people/