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  • Understanding the Intersection of Medicaid and Work: An Update

    Issue Brief

    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.

  • Medicaid Section 1115 Waivers: The Basics

    Issue Brief

    Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute. Nearly all states have at least one active Section 1115 waiver and some states have multiple 1115 waivers. This brief explains what Section 1115 waivers are and how they are used, summarizes key waiver requirements, and outlines the application and approval process.

  • Status of State Medicaid Expansion Decisions

    Interactive

    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.

  • An Overview of Medicaid Work Requirements: What Happened Under the Trump and Biden Administrations?

    Issue Brief

    The Trump Administration aimed to reshape the Medicaid program by newly approving Section 1115 demonstration waivers that imposed work and reporting requirements as a condition of Medicaid eligibility. However, courts struck down many of these approvals and the Supreme Court recently dismissed pending challenges in these cases. Available implementation data suggests that work requirements were confusing to enrollees and result in substantial coverage loss, including among eligible individuals.

  • Different Data Source, But Same Results: Most Adults Subject to Medicaid Work Requirements Are Working or Face Barriers to Work

    Issue Brief

    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.

  • Ongoing Impacts of the Pandemic on Medicaid Home & Community-Based Services (HCBS) Programs: Findings from a 50-State Survey

    Issue Brief

    This issue brief presents the latest findings on key state policy choices about Medicaid HCBS in 2022 based on the 20th KFF survey of state officials administering Medicaid HCBS programs in all 50 states and DC. The data were collected from April through September 2022. The survey was sent to each state official responsible for overseeing the administration of HCBS benefits (e.g., home health, personal care, and services for specific populations such as people with physical disabilities), but some states submitted responses for the state overall.

  • Section 1115 Waiver Watch: Continuous Eligibility Waivers

    Policy Watch

    The pandemic continuous enrollment provision and other research show that continuous eligibility reduces Medicaid disenrollment and “churn” rates and helps to ensure stable coverage. As many Medicaid enrollees are currently experiencing disruptions in coverage as a result of the Medicaid unwinding, a number of states are pursuing strategies to help promote continuity of coverage, including through unwinding waivers and Section 1115 demonstration waivers. This Waiver Watch summarizes approved and pending Section 1115 waivers with continuous eligibility provisions for children and adults in Medicaid.

  • What did Sen. JD Vance mean by ‘Reinsurance?’

    Quick Take

    Vance’s debate comment likely refers to state reinsurance waivers, largely approved by the Trump Administration. These waivers aimed to lower unsubsidized premiums by offsetting insurer costs for very sick enrollees.

  • What is Medicaid Estate Recovery?

    Issue Brief

    Under estate recovery, state Medicaid programs are required to recover the costs of long-term care and related hospital and prescription drug services for enrollees ages 55 and older. KFF examines the wide variation in estate recovery practices across states as well as the criticisms of this policy, which have led to federal proposals to modify or reduce it.

  • Medicaid Waiver Priorities Under the Trump and Biden-Harris Administrations

    Issue Brief

    Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” As with broader Medicaid policy, the future landscape of Section 1115 waivers depends on the outcome of the November 2024 presidential election as a new administration could focus on different priorities, rescind existing guidance, or withdraw already-approved waivers. This waiver watch summarizes five key areas of difference in 1115 waiver policy and waiver approvals under the Trump and Biden-Harris administrations.