Medicaid

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Medicaid work requirements

States Are Adopting a Variety of Outreach Strategies to Inform Individuals About Medicaid Work Requirements

Medicaid Work Requirements: Federal Outreach Requirements and State Plans

State Medicaid programs must inform people affected by new work requirements with federally required notices, and most states are planning other types of outreach, including phone calls, public ads, and social media posts. This brief describes the federal outreach requirements and state plans, as well as the complexities and tight implementation timelines states face.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies. The Congressional Budget Office estimates that the 2025 reconciliation law will increase the number of people who are uninsured in 2034 by 10 million. Coverage losses from Medicaid work requirements account for over half, or 5.3 million, of the increase in the number of uninsured.

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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • COVID-19 Outbreaks in Long-Term Care Facilities Were Most Severe in the Early Months of the Pandemic, but Data Show Cases and Deaths in Such Facilities May Be On the Rise Again

    News Release

    The rate of new COVID-19 cases and deaths in long-term care facilities declined markedly in May and June after the novel coronavirus swept through nursing homes in April, but recent data show the incidence may be on the rise again, according to a new KFF analysis. A second new analysis from KFF examines the impact of COVID-19 on assisted living facilities, a type of long-term care facility that, unlike nursing homes, is not federally regulated,…

  • Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic

    Issue Brief

    This brief provides an overview of how Medicaid managed care organization (MCO) capitation rates are developed by states and approved by CMS, highlights options available to states to adjust current rates and/or risk sharing mechanisms, describes how MCOs pay providers, and outlines state options to direct MCO payments to providers in response to conditions created by the COVID-19 pandemic.

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • As Unemployment Skyrockets, KFF Estimates More than 20 Million People Losing Job-Based Health Coverage Will Become Eligible for ACA Coverage through Medicaid or Marketplace Tax Credits

    News Release

    Coverage Losses Will Affect At Least a Million Residents in Each of Eight States: California, Texas, Pennsylvania, New York, Georgia, Florida, Michigan and Ohio With more than 31 million workers filing unemployment claims between March 1 and May 2 as the coronavirus crisis hit the nation’s economy, a new KFF analysis estimates 26.8 million people across the country would become uninsured due to loss of job-based health coverage if they don't sign up for other…

  • As People Lose Jobs Due to the Coronavirus Crisis and Enroll in Medicaid, Survey Finds States Anticipate Medicaid Budget Shortfalls

    News Release

    Many states that shared budget projections in response to a new KFF survey of state Medicaid officials report that they expect to see Medicaid budget shortfalls due to rising Medicaid spending and enrollment as people lose jobs amid the coronavirus pandemic and more people enroll in the government health insurance program for low-income people. KFF conducted the rapid survey of Medicaid directors in all 50 states and the District of Columbia with Health Management Associates…

  • State Actions to Facilitate Access to Medicaid and CHIP Coverage in Response to COVID-19

    Issue Brief

    This brief summarizes state changes to Medicaid and CHIP eligibility and enrollment policies in response to the COVID-19 outbreak, beyond those required to access enhanced federal funding. It is based on KFF analysis of approved Medicaid and CHIP state plan amendments (SPAs) and information on state websites as of May 21, 2020.

  • Eliminating the ACA: What Could It Mean for Medicaid Expansion?

    Policy Watch

    The debate over filling the Supreme Court seat previously held by Ruth Bader Ginsburg has brought renewed attention to the possibility of the Affordable Care Act (ACA) being overturned under the court challenge in California v. Texas, currently scheduled to be heard shortly after the election this November. The expansion of Medicaid was a central component of the ACA, and 39 states have now adopted the ACA expansion into their Medicaid programs. Because Medicaid is…

  • Medicaid Enrollment & Spending Growth: FY 2020 & 2021

    Issue Brief

    This brief analyzes Medicaid enrollment and spending trends for FY 2020 and FY 2021 based on data provided by state Medicaid directors as part of the 20th annual survey of Medicaid directors in states across the country and the District of Columbia. After relatively flat enrollment growth in FY 2020, states responding to the survey expect Medicaid enrollment to jump in FY 2021, attributed to the Families First Coronavirus Response Act “maintenance of eligibility” (MOE)…

  • 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…