Eligibility - Research and Data from KFF

As State Medicaid Programs Prepare to Resume Disenrollments, Many States Are Using a Range of Strategies to Make it Easier for People Who Remain Eligible to Retain Coverage, But in Others it Will be More Difficult

Mar 16, 2023

News Release

With pandemic-era protections for Medicaid enrollees set to expire this month, state Medicaid programs are gearing up to resume eligibility checks and disenrollments. But how the unwinding of the federal continuous enrollment provision affects enrollees and state budgets will vary according to states’ differing approaches and administrative capabilities, a new KFF survey finds. The 21st annual KFF survey of state Medicaid and Children’s Health Insurance (CHIP) Program officials finds that many states are using an…

What Does the Medicaid Eligibility Rule Mean for Low-Income Medicare Beneficiaries and the Medicare Savings Programs (MSPs)?

Nov 1, 2023

Issue Brief

On September 21, 2023, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that is intended to help low-income Medicare beneficiaries gain access to Medicaid coverage of Medicare premiums and often, cost sharing, through the Medicare Savings Programs.

Tennessee Plans to Share Data on Children with Disabilities with Immigration Authorities

Jun 29, 2026

Policy Watch

This policy watch discusses a recent Tennessee law that requires the sharing of data for applicants and/or enrollees for the state's public assistance programs who do not have a qualified immigration status with immigration authorities, including for those enrolled in the state's Children's Special Services program, which serves children with disabilities.

Medicaid and CHIP Eligibility Expansions and Coverage Changes for Children Since the Start of the Pandemic

Oct 29, 2024

Issue Brief

KFF's new analysis examines how state coverage changes and expansions in Medicaid and CHIP eligibility for children may help to bolster coverage following the unwinding of the continuous enrollment provision.

Estimates of Eligibility for ACA Coverage among the Uninsured by Race and Ethnicity

Oct 28, 2015

Issue Brief

This analysis provides national estimates of eligibility for ACA coverage options by race/ethnicity, including Whites, Blacks, and Hispanics. We estimate coverage and eligibility as of early 2015, which is prior to the end of the 2015 Marketplace open enrollment period. Overall, this analysis finds that more than half (55%) of the total 32.3 million nonelderly uninsured are people of color, including 34% who identify as Hispanic, 14% who identify as Black, and 8% who identify…

Key Themes in Medicaid Section 1115 Behavioral Health Waivers

Nov 10, 2017

Issue Brief

State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people…

A Guide to the Lawsuit Challenging CMS’s Approval of the Kentucky HEALTH Medicaid Waiver

Jan 29, 2018

Issue Brief

On January 11, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a State Medicaid Director letter announcing a new policy that, for the 1st time, allows states to condition Medicaid on participation in a work or “community engagement” program. The next day, CMS approved a new Medicaid waiver in Kentucky. The waiver includes a program called Kentucky HEALTH, which encompasses a work requirement as well as coverage lockouts of up to 6 months…

Median Medicaid/ CHIP Eligibility Thresholds, January 2013

Mar 14, 2013

Feature

Median Medicaid/CHIP Eligibility Thresholds, January 2013 Download Source Based on the results of a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, 2013

Two Medicaid-Related Initiatives That Help Promote Long-Term Care at Home and in the Community, Rather Than in Institutions, Are Set To Expire at the End of December

Nov 25, 2019

News Release

Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs. While there does not appear to be substantive disagreement over the initiatives like there is with many other federal health programs, their expiration is coming at a time when Congress is engaged in a contentious…

Medicaid Restructuring Under the American Health Care Act and Nonelderly Adults with Disabilities

Mar 16, 2017

Issue Brief

This brief describes Medicaid’s role for nearly 7 million nonelderly adults with disabilities living in the community to help inform the debate about the American Health Care Act’s proposals to end enhanced federal funding under the ACA and reduce federal Medicaid funding under a per capita cap.

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