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This page displays an interactive map of the current status of state decisions on the Affordable Care Act's Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.
On July 11, CMS notified states that, going forward, it does not anticipate approving new 1115 demonstration workforce initiatives or extending existing waivers. Such changes may limit states’ abilities to pursue initiatives investing in the Medicaid workforce.
Section 1115 Medicaid waivers can allow states to test new approaches in Medicaid that differ from what is required by federal law. This page tracks approved and pending waiver provisions (including expansions and restrictions) related to eligibility, benefits, and social determinants of health and other delivery system reforms.
CMS released guidance for states that would end waivers allowing continuous Medicaid eligibility for children and adults. Ending continuous eligibility will increase disenrollment, but not all who lose coverage are no longer eligible… more
To understand the impact of Medicaid work requirements included in the budget reconciliation bill being debated in Congress, KFF has undertaken two different analyses using different data sources. Using 2023 data from the Survey of Income and Program Participation, this analysis looks at the share of adults who work at least 80 hours per month, the reasons some do not, and how consistently individuals meet the requirement over a six-month period.
Amid renewed interest in Medicaid work requirements as part of a broader legislative package designed to significantly reduce federal Medicaid spending, KFF has updated its analysis of the work status and demographic characteristics of Medicaid enrollees with the latest data.
Data show that, in 2023, 92% of Medicaid adults were either working full or part-time (64%), or were not working due to barriers to work such as caregiving responsibilities, illness or disability, or school attendance -- reasons that counted as qualifying exemptions from the work requirements under previous policies.
On May 18, the House Budget Committee advanced a budget reconciliation bill that includes significant changes to the Medicaid program. As anticipated, Medicaid work requirement provisions are included and preliminary estimates released by the Congressional Budget Office (CBO) show that this provision would reduce federal spending by $280 billion over ten years, nearly half of all estimated Medicaid savings in the bill. The provisions raise many operational and implementation questions, particularly considering the experience of Arkansas and Georgia with implementing work requirements through waivers.
Recent actions from the Trump administration could signal limits to curtail Medicaid waivers related to social determinants of health and to limit waiver financing tools and flexibility. Two major changes demonstrate this shift: (1) rescinding Biden-era guidance on covering health-related social needs (HRSN) services, and (2) phasing out federal funding for “Designated State Health Programs” (DSHP) in waivers.
This data note documents differences by sex in the work status of adult Medicaid enrollees ages 19-64 who were not receiving Supplemental Security Income (SSI) and were not dually eligible for Medicare in 2023, and highlights differences by parent status.
This issue brief provides information about some of the services Medicaid provides in assisted living facilities from KFF’s most recent survey of state Medicaid HCBS home care programs.
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