November 20, 2025

The report identified 109 hospitals that were classified as either critical access or safety-net hospitals and were already struggling financially and serving a large portion of Medicaid patients. These facilities were frequently in urban areas, and more concentrated in the Northeast and West.

All states except Alaska rely on provider taxes—most commonly on nursing homes and hospitals—to help finance their share of Medicaid. The OBBB is projected to save taxpayers $200 billion over the next decade by prohibiting new provider-tax arrangements, limiting increases to existing taxes, and requiring Medicaid expansion states to lower the safe-harbor threshold that shields providers from the tax burden. In its new guidance, CMS outlines how it will determine which taxes were in place when the bill passed and how it will set the safe-harbor freeze threshold.

Medicaid enrollment declined this year as states unwound their pandemic-era continuous enrollment policies, but overall spending continued to rise—and looming cost increases mean even more financial pressure ahead. According to KFF, the combination of sizable Medicaid cuts and an already challenging fiscal environment will make it difficult for states to absorb or offset funding losses. Nearly two-thirds of states reported at least a 50/50 chance of facing a Medicaid budget shortfall in 2026.

As a result of an initiative from the Trump administration, Humana and partner Epic are taking action to speed patient appointment check-in and coverage verification for Medicare Advantage beneficiaries. Implementation includes new features in the electronic health record platform that allow insurance details from Humana to be automatically shared with providers before patients arrive at appointments.