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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.

Dual Eligibles

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  • Webcast: New CMS Estimates of State-by-State Health Expenditures

    Event Date:
    Event

    The Kaiser Family Foundation held a live interactive webcast on December 7, 2011, to discuss trends in state health care expenditures and the implications for national and state efforts to constrain health care costs. The webcast examines new state-by-state estimates of public and private health spending from the Centers for Medicare and Medicaid Services (CMS) published in the online journal, Medicare and Medicaid Research Review. An expert panel offers perspectives on the trends within and…

  • Eliminating Adult Dental Coverage in Medicaid: An Analysis of the Massachusetts Experience

    Report

    This report examines the impact of Massachusetts eliminating coverage of most dental services for adults in its Medicaid program, MassHealth. The report findings include: In FY2004, 100,000 fewer MassHealth adult enrollees received dental services reimbursed by MassHealth than in FY2001, the year prior to the reductions; The number of private dentists actively treating MassHealth patients declined after the reductions, and dental directors at community health centers (CHCs) indicated that they did not have the capacity…

  • 2004 State and National Medicaid Spending Data (CMS-64)

    Report

    This set of tables, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state-by-state information on Medicaid spending by services using data from the Centers on Medicaid and Medicare Services (CMS) Form 64 for Federal Fiscal Year (FFY) 2004. CMS-64 data provide a somewhat different measure of spending than does the Medicaid Statistical Information System (MSIS). Please refer to the "Overview of Differences" document below for…

  • New Publications on Immigrant Health Care and Linguistic Access

    Fact Sheet

    In 2000, there were over 32 million foreign-born residents in the U.S. Immigrants often face barriers to health coverage and health services. The disparities confronting immigrants can be similar to those faced by low-income working families generally, but immigrants also face other barriers, including linguistic issues and eligibility changes that have limited their ability to qualify for Medicaid. These new or updated publications address issues related to how race, immigration status, and language affect insurance…

  • New Medicare Drug Benefit’s Impact on States and Low-Income Beneficiaries

    Other Post

    New Medicare Drug Benefit's Impact on States and Low-Income Beneficiaries The recently signed Medicare prescription drug bill transfers responsibility for providing prescription drug coverage to dual-eligible beneficiaries from Medicaid to Medicare and creates a new subsidy program for low-income Medicare beneficiaries. These changes will have a major impact on state Medicaid programs both fiscally and administratively and it will also mean major changes for low-income beneficiaries' drug coverage. Presentation: Medicare Prescription Drugs and Low-Income Beneficiaries…

  • Dual Eligibles: Medicaid’s Role in Filling Medicare’s Gaps

    Issue Brief

    Dual Eligibles: Medicaid's Role in Filling Medicare's Gaps - Issue Brief This paper presents a profile of dual eligible beneficiaries (those qualifying for both Medicare and Medicaid), describes their health care expenditures, and analyzes the distribution of spending on the population. Issue Paper (.pdf)

  • Medicaid Financing Briefing – April 19, 2004

    Other Post

    On April 19, 2004 the Kaiser Commission on Medicaid and the Uninsured held a Washington policy briefing on the basics of Medicaid financing. A webcast and transcript of the briefing are available. Presentation Slides (.pdf) The publications below provide background information on Medicaid financing and the latest on Medicaid waiver activity. Reports related to Medicaid Financing and State Budgets Financing the Medicaid Program: The Many Roles of State and Federal Matching Funds Current Issues in…

  • Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Report

    This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and fraud and abuse. Report (.pdf)