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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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  • On Medicaid Expansion, History Matters

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman discusses the history of the battles over the ACA’s provisions that were designed to expand coverage for the uninsured, which helps explain the effort to cut federal funding for the Medicaid expansion today. The real underlying issues, he says, are the same divisions that have always plagued the debate about covering the uninsured.

  • The Spotlight Is on Medicaid Cuts, But the ACA Marketplaces Could See a One-Third Cut in Enrollment

    From Drew Altman

    In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”

  • Why Most States Will Not Replace Federal Medicaid Cuts

    From Drew Altman

    In his latest Beyond the Data column, KFF’s President and CEO Drew Altman discusses how difficult it will be for states to replace lost federal Medicaid funding should Congress make significant cuts.

  • Is Medicaid Too Big to… Block Grant?

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman examines how the politics around the Medicaid program have changed as it has grown much larger and more popular, making it even tougher to block grant the program to cut federal Medicaid spending and hand it off to the states.

  • Nearly a Quarter of People Who Say They Were Disenrolled from Medicaid During the Unwinding Are Now Uninsured   

    News Release

    Nearly a quarter (23%) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now, finds a new KFF national survey examining how the unwinding affected enrollees.  Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured, while 30% already had another form…

  • Examining New Medicaid Resources to Expand School-Based Behavioral Health Services

    Issue Brief

    In light of worsening mental health among youth, strategies have been implemented to improve access to behavioral health services in recent years, including expanding school-based care for students. Leveraging Medicaid to improve and address gaps in school-based behavioral health services has been a key strategy in recent years as youth mental health concerns have grown. Provisions from the Safer Communities Act of 2022 utilize Medicaid to expand both school-based health care and other mechanisms of…

  • The Vast Majority of Nursing Facilities Will Need to Hire More Staff to Comply with the Final Federal Rule When Fully Implemented, Unless They Qualify for an Exemption

    News Release

    Based on a new KFF analysis, fewer than 1 in 5 (19%) nursing facilities currently meet the minimum staffing standards set out in the final requirements of the federal rule released today by the Centers for Medicare and Medicaid Services (CMS). CMS adopted staffing standards that are similar to the staffing requirements in the rule proposed last year, which included minimum staff levels of 0.55 registered nurses and 2.45 nurse aide hours per resident day.…

  • What You Need to Know About Medicaid Managed Care, Amid the New Federal Rules 

    News Release

    Managed care is the most common delivery system for Medicaid. Most states (42, including DC) use comprehensive managed care plans to provide care to at least some of their Medicaid enrollees, according to KFF’s updated explainer.  Roughly 3 out of 4 Medicaid enrollees receive care through managed care organizations and payments to these organizations account for over half of total Medicaid spending. Five publicly traded firms – Centene, UnitedHealth Group, Anthem (renamed “Elevance” in 2022),…