In recent years, Medicaid spending on prescription drugs has grown, in part due to the emergence of new, high-cost drugs, including GLP-1s and cell and gene therapies that treat, and sometimes cure, rare diseases. There have been several recent Trump administration prescription drug initiatives (Box 1), including new payment models, that could help combat rising costs for state Medicaid programs, though questions remain about the implementation and impact of the deals. While lower prices for state Medicaid programs through the new models could result in reduced Medicaid prescription drug spending and potentially expanded coverage of certain drugs, the extent of the savings and how states or manufacturers will respond remain unclear. In most cases, Medicaid programs already pay lower prices, net of rebates, than other payers.

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Western Massachusetts, a patchwork of rural communities and low-income cities, is a difficult place to find a primary care doctor if you don’t already have one. Frustrated patients often turn to online forums, asking for leads or advice on how to find a practice that is accepting new patients.

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Editorial Note: This brief was updated in March 2026 to reflect the results of the second round of Medicare drug price negotiation and details about the third cycle of the negotiation program, including the list of drugs selected for negotiation in early 2026.

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Editorial Note: Originally published on September 27, 2024, this brief was updated on March 10, 2026 to incorporate new federal policy developments on contraceptive coverage.

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Eight-year-old Jonah woke up one May morning with a swollen face and a toothache. He refused the pain medication that his mom, Geneva Reynolds, tried to give him. He didn’t sleep or eat and cried constantly.

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The Centers for Medicare & Medicaid Services (CMS) has released a memo fleshing out the design of a short-term program providing Medicare coverage of GLP-1s for obesity in 2026 ahead of a multi-year demonstration program beginning in 2027. Medicare is statutorily prohibited from covering drugs used for weight loss, and these demonstration programs are designed to fill that gap.

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In December, Nebraska was the first state to announce that it would be enforcing Medicaid work requirements early, starting May 1, 2026. The 2025 reconciliation law requires states to condition Medicaid eligibility for adults in the ACA Medicaid expansion group and enrollees in partial expansion waiver programs (Georgia and Wisconsin) on meeting work requirements starting January 1, 2027; however, states have the option to implement requirements sooner through a state plan amendment (as is the case for Nebraska) or through an approved 1115 waiver.

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KFF Resources on Medicaid Work Requirements

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Passage of the 2025 reconciliation law, also known as the “One Big, Beautiful Bill,” in July 2025 and the inclusion of new work requirements for certain Medicaid enrollees in the law focused attention on the work status of adults enrolled in the program as well as their access to job-based insurance. Most adults who will be subject to the new Medicaid work requirements are already working. 

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OTTUMWA, Iowa — Leisa and Kent Walker recently received a disturbing notice: The private company managing their son’s Medicaid coverage intends to cut nearly 40% of what it spends for caregivers who help him live at home instead of in a nursing home.

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