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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.

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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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  • Incremental Ways to Cover the Uninsured

    Other Post

    The Kaiser Commission co-sponsored a policy briefing on America's uninsured population and potential models for coverage expansion. Expanding public programs and providing tax credits are both being discussed as ways to cover some of the 42 million uninsured Americans. A link to the webcast and related resources is provided. Webcast of Policy Briefing

  • Health Insurance Coverage of Low-Wage Workers

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    This fact sheet summarizes the reasons why low-wage workers are less likely to have employer-sponsored health insurance than workers with higher incomes and therefore, are more likely to be uninsured. Fact Sheet

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    Report

    The Medicaid Primer presents in depth information on Medicaid, the federal/state program that provides health coverage for low-income families and people with disabilities and is the largest source of public financing for HIV/AIDS care in the U.S. The Medicaid Primer is designed to help policymakers and advocates navigate through the complexities of Medicaid with regard to the program's role for people with HIV/AIDS. REPORT Download

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    Report

    This report reviews how states have responded to the $500 million federal fund that was created by the federal welfare reform legislation in 1996 to help states maintain Medicaid coverage for individuals affected by welfare reform. State Medicaid officials were asked whether they have drawn down federal funds from the $500 million fund; to describe the factors that influenced their decision; and what activities they are supporting with the additional federal monies. The paper describes…

  • Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

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    Other Post

    The Kaiser Commission on Medicaid and the Uninsured highlighted two new reports at the policy briefing, , and released several related publications at the event. Reaching Uninsured Children Through Medicaid: If You Build It Right, They Will Come (.pdf) Enrolling Children and Families in Health Coverage: The Promise of Doing More (.pdf) Medicaid Program Enrollment: Data Update September 2001 (.pdf) SCHIP Program Enrollment: December 2001 Update (.pdf) Acceleration of Medicaid Spending Reflects Mounting Pressures (.pdf) Medicaid Update: What Changes Are…

  • Health Insurance Premiums and Cost-Sharing: Findings from the Research on Low-Income Populations

    Issue Brief

    Health Insurance Premiums and Cost-Sharing: Findings from the Research on Low-Income Populations This policy brief reviews studies on the impact of premiums and cost-sharing, particularly on low-income populations, and finds that premiums generally depressed participation in public programs and cost-sharing affected health utilization, access and outcomes. Policy Brief