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

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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.

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.

Dual Eligibles

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  • Medicare Prescription Drug Coverage for Residents of Nursing Homes and Assisted Living Facilities: Special Problems and Concerns

    Issue Brief

    This issue brief describes Medicare drug benefit policy issues for residents of nursing homes and other long-term care settings, such as assisted living facilities and board and care facilities. The brief addresses differing rules for nursing home and non-nursing home settings, as well as for dual eligibles residing in long-term care facilities. Issue Brief (.pdf)

  • New Reports Explore State Implementation of Prescription Drug Prior Authorization

    Other Post

    States are grappling with a fiscal crisis that threatens funding for Medicaid, the federal-state partnership that provides health coverage for low-income populations. Two new studies shed light on the impact of an increasingly popular strategy - prior authorization - being used to control prescription drug spending. In fiscal year 2003, some 21 states are planning to expand or create prior authorization systems where the state must provide pre-approval before selected drugs can be dispensed to…

  • State Perspectives on Medicaid Long-term Care: Report from a July 2003 State Forum

    Report

    This report summarizes discussions on Medicaid and long-term care at a forum with state officials held by the Kaiser Commission on Medicaid and the Uninsured in July of 2003. The forum, conducted by the National Academy of State Health Policy, addressed issues including Medicaid's role in long-term care, state fiscal crises and cost-containment strategies, and how state long-term care programs are evolving. Report (.pdf)

  • Dual Eligibles Tables: Enrollment and Spending, by State, 2002

    Report

    This set of tables, prepared by the Urban Institue for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state by state data on Medicaid enrollment and expenditures for dual eligibles. Full Set of Tables (.pdf) Individual Tables:Implications of the Medicare drug law for full dual eligibles:Table 1: “Full” Dual Eligible Enrollment and Prescription Drug Expenditures, by State, 2002 (.pdf) Enrollment and spending data for full and partial dual eligibles:Table 2: Total…

  • Health Coverage for Individuals Affected by Hurricane Katrina:

    Issue Brief

    A Comparison of Different Approaches to Extend Medicaid Coverage Approaches have been put forward to extend Medicaid coverage to Hurricane Katrina survivors, but they differ significantly regarding the extent to which they extend Medicaid eligibility and in the role of federal funding for coverage of Hurricane survivors. This publication provides an overview of these approaches and their key differences. First is a table comparing the major components of the September 15, 2005 Senate bill, the…

  • Reports Explore Long-Term Care Issues Included in the Deficit Reduction Act

    Issue Brief

    The Deficit Reduction Act (DRA) of 2005, which became law this February, includes several significant changes to Medicaid long-term care policies. The Kaiser Family Foundation's Commission on Medicaid and the Uninsured is releasing five new reports on long-term care issues that were addressed by the DRA changes. Long-term care accounts for 36 percent of Medicaid spending (over $100 billion annually) and is utilized by many of Medicaid's most costly beneficiaries, the low-income elderly and individuals…

  • Who Needs Medicaid?

    Issue Brief

    This brief reviews Medicaid’s current eligibility structure and the health needs of the people covered by Medicaid. Due to the trends of limited and declining access to private health coverage in the low-income population and the growing health and long-term care demands of an aging population, a broader model for Medicaid eligibility is considered and the implications of recent legislative and policy developments for coverage are assessed. Issue Brief (.pdf)