KFF

An estimated $60 billion in federal Medicaid spending in 37 states (including the District of Columbia) would likely exceed new federal limits on state directed payments for hospital services once fully implemented, a new KFF analysis finds. States with the biggest potential reductions in Medicaid payments to hospitals include California, Illinois, Kentucky, Texas, North Carolina, Louisiana, Arizona and Michigan.

While the DHS guidance provides more details on public charge determinations under the new rule, it leaves key concepts unspecified and grants substantial discretion to individual immigration officers. This will likely result in ongoing confusion and fear among immigrant families that may deter them and their citizen children from participating in programs that help pay for health care, housing, or food even if they are eligible. KFF

Key Questions The 2025 reconciliation law imposes significant new restrictions on states' ability to generate Medicaid provider tax

States and local governments, rather than the federal government, have authority over school vaccination requirements, and while all 50 states and DC require certain vaccines for school attendance, they vary substantially in how exemptions are granted and administered. As the Trump administration has moved away from longstanding federal childhood vaccine recommendations, an increasing number of states are delinking their vaccine policies from CDC/ACIP guidance, while recent state policy changes have generally made non-medical exemptions easier to obtain—trends that could affect school vaccination requirements and coverage.

On August 25 , 2026, the Department of Homeland Security (DHS) published a proposed rule to establish a $103,265 fee on every H-1B visa petition subject to the annual visa cap.

Considering the existing challenges to hospital-based maternity care in rural areas and the potential for it to worsen, this data note analyzes the availability of hospitals providing inpatient maternity care in rural areas for Medicaid enrollees and illustrates how access to these services could be affected if additional rural hospitals were to close or eliminate those services.

This data note presents key data points describing the current state of the Medicaid program as it affects women.

States are taking different regulatory approaches to AI mental health tools in response to concerns about chatbots providing inaccurate or potentially dangerous advice. Laws and pending legislation in some states restrict AI from providing or advertising itself as therapy, while others focus on data protections, disclosures, and patient consent requirements.

This report examines how LGBTQ+ adults' experiences with health care costs and access compare to those of non-LGBTQ+ adults, finding that LGBTQ+ adults face significantly greater challenges affording and accessing care.

This publication describes KFF's survey methodology and data collection standards, including how the polling team reaches survey respondents, works to be representative, and partners with other news organizations on its polling projects.