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

Event Date:

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 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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  • Money Follows the Person: A 2010 Snapshot

    Issue Brief

    Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the Money Follows the Person demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. In July 2010, the Kaiser Commission on Medicaid and the Uninsured (KCMU) surveyed states about the current status of their MFP program including trends in enrollment, services and per capita spending.

  • Money Follows the Person Transitions Individuals from Nursing Homes to the Community

    Issue Brief

    This brief presents short profiles of four Ohio residents who have benefited from the state's Money Follows the Person demonstration program, known as HOME Choice. It was released along with several other resources on Medicaid long-term services and supports at a Feb. 7, 2011 briefing at the Foundation's Washington, D.C., offices. Profiles (.pdf)

  • Case Study: Ohio’s Money Follows the Person Demonstration (HOME Choice)

    Issue Brief

    This case study of Ohio's Money Follows the Person demonstration, known as HOME Choice, describes key features of the program and highlights early program experiences. Ohio was one of 17 states to receive federal funding for the Money Follows the Person (MFP) rebalancing demonstration in January 2007. The state was awarded up to $100 million in enhanced federal matching funds in order to transition roughly 2,200 seniors and people with disabilities from institutions to home…

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…

  • New Resources & Briefing Examine Medicaid Long-Term Services and Supports

    Event Date:
    Event

    The following resources by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) examine the latest data findings regarding Medicaid’s long-term services and supports for seniors and people with disabilities. The materials were released at a public briefing in the Foundation’s Washington, D.C. offices that featured an expert panel and remarks on long-term services and supports by U.S. Secretary of Health and Human Services Kathleen Sebelius. The reports include: Medicaid Home and Community-Based…

  • Helping Consumers Manage Long-Term Services and Supports in the Community: State Medicaid Program Activities

    Issue Brief

    The Medicaid program is a source for many innovative practices in making long-term services and supports (LTSS) available to consumers. Jointly financed by the states and the federal government, Medicaid pays for 40 percent of LTSS spending the United States. Case management services have been integral to Medicaid community-based LTSS programs since their inception, but as the programs have grown and evolved, particularly as options for care have increased and consumers have taken a more…

  • With Federal Support, States Hold Steady in Medicaid and CHIP Coverage Policies for Low-Income Children and Families Despite Recession

    News Release

    New 50-State Survey Finds Some States Make Targeted Expansions to Strengthen Coverage and Achieve Efficiencies as They Prepare for Health Reform WASHINGTON -- Despite tight budgets, nearly all states maintained or made targeted expansions or improvements in their Medicaid and Children’s Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, preserving the programs’ ability to provide coverage to millions of low-income Americans who otherwise lack affordable options, according to a new survey released today…

  • Waiting for Economic Recovery, Poised for Health Care Reform: A Mid-Year Update for FY 2011 – Looking Forward to FY 2012

    Report

    This report, based on structured discussions in November and December 2010 with leading Medicaid directors, augments the findings from the most recent comprehensive 50-state Medicaid budget survey to provide a mid-year 2011 update on state Medicaid issues. As they prepare their fiscal 2012 budgets, many states, some under new gubernatorial and legislative leadership, continue to cope with lingering effects of the worst recession in decades and are facing budget shortfalls, with revenues remaining below pre-recession…

  • Medicaid’s New “Health Home” Option

    Issue Brief

    This brief provides key information about the new option for state Medicaid programs to provide "health home" services for enrollees with chronic conditions. The option, established under the new health reform law, took effect on Jan. 1, 2011. Health homes are designed to facilitate access to and coordination of the full array of primary and acute physical health services, behavioral health care and long-term community-based services and supports. Brief (.pdf)

  • Holding Steady, Looking Ahead: Annual Findings Of A 50-State Survey Of Eligibility Rules, Enrollment and Renewal Procedures, And Cost Sharing Practices in Medicaid and CHIP, 2010-2011

    Report

    The annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost sharing practices, conducted by the Kaiser Commission on Medicaid and the Uninsured with the Georgetown University Center for Children and Families, found that, in 2010, coverage in Medicaid and the Children's Health Insurance Program remained strong with some improvements, particularly for low-income children. However, eligibility for their parents and other low-income adults continued to lag behind. The survey also…