Kaiser Family Foundation

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. The 2025 reconciliation law made major changes to Medicaid eligibility and financing, including new limits on how much states can direct Medicaid managed-care organizations to pay for certain services, including hospital care.

The 2025 reconciliation law reduced federal Medicaid spending by an estimated $911 billion from 2025 through 2034, some of which stems from new restrictions on Medicaid state directed payments (SDPs) for hospital and other health care services. While states are generally prohibited from directing how managed care organizations (MCOs) pay for care, states can implement SDPs that require MCOs to increase rates or set minimum rates for specified Medicaid services.

Actions taken by the Trump administration and Congress will likely have major impacts on health and health care for immigrant families, including reducing the number of lawfully present immigrants eligible for federally funded health coverage under the 2025 reconciliation law.

On August 11, 2026, the Centers for Medicare and Medicaid Services (CMS) issued a much-anticipated final rule prohibiting federal Medicaid or Children’s Health Insurance Program (CHIP) funds from covering certain gender-affirming care services for young people. This follows a proposed rule issued in December 2025. CMS received nearly 35,000 comments on the proposal, and of the 11,000 comments posted, CMS writes that more than 90% were in opposition to the policy change.

VOLUME 52 August 13, 2026 Recently released findings from KFF’s July Health Tracking Poll show that much of the public is unsure of the abortion pill mifepristone’s safety, and most lack awareness that most abortions in the U.S. are performed via medications.

Introduction The use of prior authorization by health insurers has come under increased scrutiny in recent years, as nearly 7 in 10 insured adults say prior authorization is a burden when it comes to getting health care. Health insurers use prior authorization to reduce the use of low-value or unnecessary care, and in the complex and fragmented U.S. health care system is one of the primary tools used to restrain costs.

A new Executive Order (EO) released by the White House on Monday is the latest in a series of administration actions seeking to change U.S. childhood vaccine recommendations.

Medicaid services are financed via two pathways: fee-for-service (FFS) and managed care arrangements. The reimbursement rates presented in this brief are for FFS claims, as contracted managed care rates are not typically publicly available. The FFS reimbursement rates reported in this brief are for non-facility (e.g., outpatient clinics or physician offices), provider-only rates (e.g., excluding any facility rates), since most abortions are performed outside of a hospital setting.

On August 5, 2026 the U.S. Food and Drug Administration (FDA) approved the first-ever messenger RNA (mRNA) flu vaccine for adults 50 and older. Manufactured by Moderna, the vaccine is expected to be available for the 2026-2027 season. The new vaccine was found to be safe following a trial of roughly 40,000 people, with results indicating the new shots could offer more protection than prior flu vaccines.

Small businesses that offer health insurance to their employees could see health costs rise in 2027, according to an analysis of preliminary rate filings from all 50 states and DC. Nearly 300 insurers offering small group coverage reported a median proposed premium increase of 14% for next year. Small group insurers say rising medical prices, including for hospitalizations, physician care, and prescription drugs, and increased utilization are major drivers of the premium increases.