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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    Other Post

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  • State Facts: Health Needs, and Medicaid Financing

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    This data book provides a profile of selected indicators of health needs, insurance coverage, and the role of Medicaid in each state with comparative statistics for the United States. Fact Sheet: California Facts

  • Where is Medicaid Spending Headed? – Report

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  • Where is Medicaid Spending Headed?

    Other Post

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  • Primer on the Federal Budget, July 1997

    Report

    This report provides information on key budgetary facts and trends and highlights federal spending in health care programs. It includes an overview of federal revenues and spending in fiscal year 1995, an overview of the budget "window" from fiscal year1996 through fiscal year 2002, and the historical context for the budget debate, from fiscal 1973 through fiscal year 2002. Chartbook: Primer on the Federal Budget

  • Medicaid and Block Grant Financing Compared

    Issue Brief

      - Issue Brief State and federal budget pressures, rising health care costs, and new waiver initiatives have promoted debate over restructuring Medicaid at the federal and state level. Questions about how Medicaid is financed are central to this debate. This paper compares the current Medicaid financing system to a generic block grant financing system to illustrate the key differences in the structure and incentives of these alternative approaches. Issue Brief (.pdf)  

  • Legislative Summary: State Children’s Health Insurance Program – Fact Sheet

    Fact Sheet

    State Children's Health Insurance Program Summary November 1997 Nearly 10 million children are uninsured, often resulting in difficulties in obtaining needed health care. To expand coverage to low-income uninsured children, Congress enacted the State Children's Health Insurance Program (CHIP) as part of the Balanced Budget Act (BBA) of 1997 (P.L. 105-33). This new program allocates $20.3 billion in federal matching funds over five years to states to expand insurance for children. States can use the…