The budget reconciliation bill (H.R. 1), signed into law on July 4, 2025, includes major overhauls to the Medicaid program. Preliminary estimates from the Congressional Budget Office projected that the Senate version of the bill (later passed by House) would reduce federal spending on Medicaid by more than $1 trillion over the next ten years and increase the number of uninsured by 11.8 million.
As the federal budget bills were being considered, various federal and state agencies, advocates, and research organizations all sought to estimate the potential impacts on Medicaid programs. Expenditure and enrollment estimates across all 50 states offered valuable insights into the implications of these proposals. These estimates were helpful tools for state staff as they considered how federal policy changes might impact their unique Medicaid programs.
Many individual state agencies also publicly released their own estimates seeking to quantify the potential impacts of federal policy changes on their respective state Medicaid programs (see below).
