Medicaid: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce federal funding for Medicaid, placing new financial pressures on states and health care providers. The impacts of the changes will vary across states and will be especially significant for states that have expanded Medicaid under the Affordable Care Act and will be required to implement new Medicaid work requirements starting next year. On July 23, 2026, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and the people who rely on Medicaid.