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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s Medicaid Work Requirements: Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

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 uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

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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  • The Adequacy of Health Insurance

    Event Date:
    Event

    Testimony by Diane Rowland, executive vice president and executive director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, at a congressional hearing, titled “Addressing Underinsurance in National Health Reform,” held Feb. 24, 2009, by a special task force of the Senate Committee on Health, Education, Labor, and Pensions. Rowland discussed the status of health insurance coverage in America and the gaps and limits to coverage that leave millions of Americans poorly protected…

  • Congressional Testimony on Expanding Health Care Coverage

    Event Date:
    Event

    On May 5, 2009, the U.S. Senate Committee on Finance held a roundtable discussion on health-care coverage issues as part of its health reform efforts. Diane Rowland, the Foundation's Executive Vice President and Executive Director of the Kaiser Commission on Medicaid and the Uninsured, and Gary Claxton, Foundation Vice President and Director of the Health Care Marketplace Project, participated in the discussion and prepared written testimony at the committee's request. Testimony of Diane Rowland (.pdf)…

  • Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

    Fact Sheet

    This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and the demonstrations in each state are set to begin in April 2013. Fact Sheet (.pdf)

  • An Implementation Perspective on Part D, the Medicare Prescription Drug Program

    Report

    This focus group of 12 state Medicaid officials conducted in November 2005 explores the current status and likely results of the Part D dual eligible transition efforts as well as other Part D-related issues of particular importance to states. It includes discussion of the transition of dual eligibles from Medicaid to Medicare drug coverage, evaluating Part D plan options, states’ role in the low-income subsidy program, the fiscal implications of Part D to states, and…

  • Choices Under the New State Child Health Insurance Program: What Factors Shape Cost and Coverage? – Policy Brief

    Issue Brief

    Choices Under The New State Child Health Insurance Program: What Factors Shape Cost And Coverage? January 1998 The State Children's Health Insurance Program (CHIP), enacted as part of the Balanced Budget Act of 1997, provides over $20 billion in federal funds over five years to cover low-income uninsured children. This program gives states considerable flexibility in designing expanded health insurance coverage for children. The way states design their programs -- use of Medicaid or a…

  • CHIP TIPS: CHIP Financing Structure

    Issue Brief

    This brief, the fourth in a series, examines important changes to CHIP’s financing structure under the Children’s Health Insurance Program Reauthorization Act of 2009. The law includes a number of important programmatic and financing changes that affect both Medicaid and CHIP. Among the most important changes include significant new funding for the CHIP program, changes in the formula for distributing CHIP funds among states and a new option for states to decide whether to use…

  • Pulling it Together: Teaching An Old Dog New Tricks

    Perspective

    Way back in the eighties when I was Human Services Commissioner in New Jersey, I established something called the Garden State Health Plan (GSHP).  It was the first — and I think the only — federally qualified state-run HMO for Medicaid beneficiaries.  One goal of the GSHP was to reallocate the Medicaid dollar, giving more to primary care physicians who at the time were paid $9 for a general office visit, and a little less…

  • Medicaid Long-Term Services and Supports: Key Changes in the Health Reform Law

    Issue Brief

    This issue brief examines new opportunities under the health reform law for states to balance their Medicaid long-term care delivery systems by expanding access to Medicaid home and community-based services (HCBS) programs. The brief outlines key provisions of the new law that expand HCBS benefit options, broaden financial and functional eligibility criteria, and provide additional financial incentives for states to further shift their Medicaid long-term services budgets to non-institutional settings. Issue Brief (.pdf)

  • Hispanics and the New Medicare Drug Benefit

    Poll Finding

    In a few short weeks, Medicare will undergo big changes that will have a major impact on more than 3 million Hispanic seniors and younger people with permanent disabilities who rely on Medicare for their health coverage. More than one in three Hispanics with Medicare lack coverage for their prescription drugs for at least part of the year. Many others will need to make decisions about their existing coverage and the new Medicare benefit. Starting…

  • Special Needs Plans: Availability and Enrollment

    Report

    Special Needs Plans are a form of Medicare Advantage plan authorized to provide a managed care option for beneficiaries with significant or relatively specialized care needs, including Medicare beneficiaries who are dually eligible for Medicare and Medicaid, beneficiaries living in nursing homes or other institutions, and beneficiaries with severe chronic or disabling conditions. This data spotlight examines availability and enrollment trends for Special Needs Plans, which account for a small share of enrollment today but…