Medicaid

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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

understanding medicaid

Medicaid Financing

Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term care. This brief examines key questions about Medicaid financing and how it works.

Medicaid Program Integrity

This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.

Medicaid and Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief describes states’ current provider taxes and explores how rules governing provider taxes are changing.

Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

Medicaid Home Care

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services”) is, who is covered, and what services were available in 2025.

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  • How Many Uninsured Adults Could Be Reached If All States Expanded Medicaid?

    Issue Brief

    As more people lose their jobs and accompanying ESI, more may fall into the coverage gap, particularly starting in 2021 after unemployment benefits expire for many who have lost their jobs and incomes are likely to drop below the minimum threshold for marketplace subsidies. This analysis estimates how many uninsured adults—including those uninsured even before the pandemic and those who could become uninsured as a result of it— could become eligible for Medicaid if states…

  • Medicaid Work Requirements and People with HIV

    Issue Brief

    This data note examines the potential implications of work requirements for people with HIV, a population that relies heavily on Medicaid and for whom there are important clinical and public health reasons for maintaining consistent access to insurance coverage and HIV care.

  • Overview of Medicaid Per Capita Cap Proposals

    Issue Brief

    The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per…

  • New Survey Finds 72% of Previously Uninsured Californians Now Have Coverage, Including 78% of Those Eligible for New Affordable Care Act Options

    News Release

    For Remaining Uninsured Residents, Cost and Immigration Status Are Main Obstacles Three years after the Affordable Care Act’s coverage expansions were fully implemented in California, nearly three quarters (72%) of the state’s previously uninsured residents now have health coverage, finds the fourth Kaiser Family Foundation Longitudinal Panel Survey, which is tracking the experiences of a randomly selected group of Californian adults who were uninsured in 2013. This is similar to the share who reported having insurance…

  • The Impact of the Pandemic on Well-Child Visits for Children Enrolled in Medicaid and CHIP

    Issue Brief

    This issue brief examines well-child visit rates overall and for selected characteristics before and after the pandemic began and discusses recent state and federal policy changes that could impact children’s preventive care. More than half of children under age 21 enrolled in Medicaid or CHIP received a well-child visit in 2019, but the share fell to 48% in 2020, the start of the COVID-19 pandemic.

  • Record ACA Marketplace Signups for 2024 Are Driven in Part by Medicaid Unwinding and More Affordable Coverage 

    News Release

    Enrollment in the Affordable Care Act (ACA) Marketplaces will hit another record high in 2024, with sign-ups to date topping 20 million—already 4 million above last year’s record high. The Medicaid unwinding, enhanced Marketplace subsidies that make coverage more affordable, as well as increased marketing, outreach, and enrollment assistance have all played a role in this growth, according to a new analysis from KFF. Marketplace sign-ups have nearly doubled since 2020. The Medicaid unwinding is…

  • More Children are Losing Medicaid Coverage as Child Poverty Grows 

    News Release

    Children’s Medicaid and Children’s Health Insurance Program (CHIP) enrollment declined by 5.5%, or 2.3 million children, from March 2023, before the unwinding began, to September 2023, according to KFF’s latest analysis. Across all 50 states and DC, at least 14,377,000 people were disenrolled from Medicaid between April 1 and January 9, 2024. Medicaid eligibility levels are higher for children, raising concerns that they may be losing coverage and becoming uninsured despite remaining eligible. Medicaid covers…

  • Few Nursing Facility Residents and Staff Have Received the Latest COVID-19 Vaccine

    Issue Brief

    KFF analysis found that over one-fifth of all U.S. COVID-19 deaths occurred in long-term care facilities despite but as of January 14th, 2024, only 38% of residents and 15% of staff were “up-to-date” with their COVID-19 vaccines, which the CDC defines as having received the updated Fall 2023 vaccine. Those rates are lower than uptake was for the 2022 vaccine.