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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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  • Medicaid:  Current Benefits and Flexibility

    Issue Brief

    Medicaid: Current Benefits and Flexibility Two issue briefs discuss the minimum requirements for states to receive federal Medicaid matching funds and the options states have under federal law and waivers to tailor their Medicaid programs. Medicaid as a Health Insurer: Current Benefits and Flexibility Medicaid as a Long-term Care Program: Current Benefits and Flexibility

  • SCHIP-Enrolled Children with Special Health Care Needs

    Report

    : An Assessment of Coordination Efforts Between State SCHIP and Title V Programs This study explores how the State Children’s Health Insurance Program serves children with special needs and assesses the role of the Title V Maternal and Child Health Services Block Grant program in filling in gaps in coverage. It also discusses the implications of state choices on publicly-funded health coverage for pediatric health care. Report (.pdf)

  • The Changing Medicaid Managed Care Market

    Report

    Trends in Commercial Plans' Participation This background paper analyzes the trends in commercial plan participation in the Medicaid market by using a database specifically designed for this purpose. It examines changes from mid-1996 to mid-1997 in the types of full-risk plans serving Medicaid Beneficiaries. It also looks at trends through mid-1998 for the 15 states with the largest number of Medicaid enrollees. Background Paper: : Trends in Commercial Plans' Particpation

  • Enrollment Increases in State CHIP Programs: December 1998 to June 1999

    Report

    A new survey of state officials, conducted by Vernon Smith of Health Management Associates for the Kaiser Commission on Medicaid and the Uninsured, found that the number of children enrolled in stateCHIP programs has grown to more than 1.3 million in June 1999 from about 835,000 in December 1998. The survey was released at the July 30th Alliance for Health Reform Briefing on state efforts to enroll more kids in the Children's Health Insurance Program.…

  • Join the Debate: Health Issues in the 2000 Election

    Other Post

    Developed as part of a nonpartisan public education initiative of the Henry J. Kaiser Family Foundation and the League of Women Voters Education Fund, this guide provides basic facts about five key health policy topics candidates are discussing in the 2000 election. These topics include health coverage for the uninsured, managed care and patients' rights, Medicare reform, prescription drug coverage for seniors, and long-term care. The guide frames each area and describes major proposals that…

  • Financing Health Coverage:  The State Children’s Health Insurance Program Experience

    Issue Brief

      Financing Health Coverage: The State Children's Health Insurance Program Experience Enactment of SCHIP sought a balance between increasing funds available for coverage and limiting total federal outlays. While SCHIP has had widespread support and success in helping to provide coverage for uninsured children, its capped financing system has also created challenges for states, including inequities among states and projected federal funding shortfalls. This issue brief explores three basic sets of issues associated with SCHIP’s…

  • Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005

  • Medicaid:  An Overview of Spending on “Mandatory” vs. “Optional” Populations and Services

    Issue Brief

    Medicaid: An Overview of Spending on "Mandatory" vs. "Optional" Populations and Services This issue brief provides an overview of Medicaid’s optional beneficiaries and services. The brief demonstrates that although “optional” populations account for only 29 percent of Medicaid enrollment, 60 percent of all Medicaid expenditures for both “mandatory” and “optional” populations are “optional,” and the majority of these (86 percent) pay for services provided to the elderly and disabled. Issue Paper (.pdf)