Medicaid

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.

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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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  • Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic

    Issue Brief

    This data note looks at state Medicaid managed care enrollment data through March 2021 to assess the impact of the COVID-19 pandemic and economic crisis on Medicaid enrollment. Data collected for 29 states show that the rate of Medicaid managed care enrollment growth was 18.8% when comparing managed care enrollment from March 2020 through March 2021. The rate accelerated compared to March 2020 through September 2020 and reversed the trend seen from March 2019 to…

  • Medicaid and the 2003-05 Budget Crisis–State Case Studies

    Other Post

    This series of case studies examines how eight states (Alabama, California, Colorado, Massachusetts, Michigan, New York, Texas, and Washington) from around the nation responded to their budget crises from 2003 to 2005, with a focus on how Medicaid and State Children's Health Insurance Programs were affected. Additionally, an overview of the eight states' experiences was published in the journal Health Affairs. Health Affairs article (free access)Three Years Of State Fiscal Struggles: How Did Medicaid And…

  • Pulling It Together: Predictions

    Perspective

    I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS.  One reason for this is the lingering effect of the recession.  Employers will have little trouble attracting workers in the…

  • The Latest Data on Mandatory and Optional Populations and Benefits in Medicaid

    Report

    With discussions on restructuring Medicaid occurring in state capitols and Washington, two new reports provide the latest data on how much of Medicaid's spending is for covering mandatory versus optional populations and services. The analysis shows that although optional populations account for 29 percent of Medicaid enrollment, 60 percent of all Medicaid spending (whether for mandatory or optional populations) is optional and 86 percent of optional spending is for the elderly or individuals with disabilities.…

  • National Survey of the Public’s Views About Medicaid

    Poll Finding

    National Survey of the Public's Views About Medicaid This national survey of the public reveals that Americans view the Medicaid program positively and are reluctant to see state and federal cuts to the program. The survey also asked the public about their knowledge of the Medicaid program. Chartpack Toplines

  • Implementing the ACA’s Medicaid-Related Health Reform Provisions After the Supreme Court’s Decision

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). A majority of the Court also found the ACA’s Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied by limiting the Health and Human Services (HHS) Secretary’s enforcement authority. The practical effect of the Court's decision makes the Medicaid expansion optional for states. This brief addresses questions…

  • Coverage of Preventive Services for Adults in Medicaid

    Issue Brief

    This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to cover such services for adults. The Affordable Care Act (ACA) provides states the opportunity to earn a one percentage point increase in their federal matching…

  • Why Does Medicaid Spending Vary Across States: A Chartbook of Factors Driving State Spending

    Report

    This detailed chartbook provides an illustrative overview of some of the key factors that contribute to the substantial variation in Medicaid spending across states today. The chartbook provides a broad range of state-by-state data on subjects including state revenue and spending, the demand for public services, health care markets, and state Medicaid policy choices. Understanding this variation can be important for assessing state fiscal issues, the differences across states and their implications for federal and…

  • Long-Term Care:  Understanding Medicaid’s Role for the Elderly and Disabled

    Issue Brief

    Long-Term Care: Understanding Medicaid’s Role for the Elderly and Disabled This updated report provides a review of how Medicaid works for people with long-term care needs and describes the fiscal challenges that states currently face and that Medicaid may face in the future as the population ages. Report (.pdf) Executive Summary (.pdf)