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Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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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  • A Court Ruling Striking Down the ACA Would Eliminate the Medicaid Expansion and Cause Millions of Low-Income People to Become Uninsured

    News Release

    Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November, KFF experts explain in a new Policy Watch post. Overturning the ACA would eliminate the expansion of Medicaid, which largely has been financed by the federal government, and eliminate eligibility for Medicaid for low-income…

  • From the Federal Response to COVID-19 to Ongoing Efforts to Repeal the ACA and Proposals for Lowering Drug Prices, President Trump Has an Extensive Record on Health Care

    News Release

    Since taking office in 2017, President Trump has laid down an extensive record on health care, including his response to the COVID-19 pandemic, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency. President Trump’s record on health care provides a window into…

  • Limits and Opportunities of Federal Reporting on COVID-19 in Nursing Facilities

    Issue Brief

    In response to the widespread concerns about the high numbers of coronavirus cases and deaths in long-term care (LTC) facilities, CMS recently implemented new COVID-19 data reporting requirements for all federally certified nursing facilities. The newly-released federal data builds on state-reported data that has been included in many, but not all, states’ regular coronavirus reporting for several weeks. However, preliminary analysis indicates that the federal data will not reveal the full extent of the crisis…

  • A Reconfigured U.S. Supreme Court: Implications for Health Policy

    Issue Brief

    U.S. Supreme Court decisions shape health policy in important ways. The nomination of Judge Amy Coney Barrett, if confirmed, is expected to establish a solid 6:3 conservative majority that could affect case outcomes in several areas. This issue brief considers the potential implications of a reconfigured Court for health policy issues, including those already on the Court’s docket for the coming term and those that the Court may choose to consider in this term or…

  • Explaining Armstrong v. Exceptional Child Center: The Supreme Court Considers Private Enforcement of the Medicaid Act

    Issue Brief

    On January 20, 2015, the United States Supreme Court will hear oral argument in Armstrong v. Exceptional Child Center, a case that raises the issue of whether Medicaid providers can challenge a state law in federal court on the basis that it violates the federal Medicaid Act and therefore is preempted by the Supremacy Clause of the U.S. Constitution. This issue brief examines the major questions raised by the Armstrong case, explains the parties’ legal…

  • Safety-Net Emergency Departments: A Look at Current Experiences and Challenges

    Issue Brief

    Safety-net hospital emergency departments (EDs) are an important part of our health care system, especially, but not only, for the uninsured and others with low income. With multiple major changes unfolding in our system today, including the development of new models of health care delivery, payment reforms, expanded insurance coverage, and increasing demand for primary care access, safety-net EDs are a sort of crucible in which these shifts and transitions can be seen playing out.…

  • Trends in Medicaid Spending Leading up to ACA Implementation

    Issue Brief

    This paper presents data on Medicaid spending during the years leading up to the implementation of the Affordable Care Act (ACA). It uses administrative data to first examine overall spending trends and trends by service type. We then draw on additional data to analyze per enrollee spending growth during this period, both by service type and by eligibility group, to understand what drove Medicaid spending.