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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s Medicaid Work Requirements: Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

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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  • Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements

    Fact Sheet

    One mechanism for ensuring that health insurance provides value to consumers for the premiums that they pay, or that others pay on their behalf, is to require insurers to meet a minimum “medical loss ratio” or MLR standard. The MLR is the share of premium revenues that an insurer or health plan spends on patient care and quality improvement activities, as opposed to administration and profits. In a recent 50-state survey on Medicaid managed care,…

  • How is the Affordable Care Act Leading to Changes in Medicaid Today? State Responses to Five New Options

    Issue Brief

    This policy brief examines how states in every region have responded to five key opportunities available under the health reform law to help them prepare for the significant expansion of Medicaid in 2014. The options covered in the brief include incentives for states to get an early start on the Medicaid coverage expansion; increased federal funding to upgrade Medicaid eligibility systems; money to improve care for beneficiaries with chronic conditions by providing "health home" services;…

  • A Guide to the Supreme Court’s Decision on the ACA’s Medicaid Expansion

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court issued its decision in the case challenging the Affordable Care Act (ACA). The Court upheld the constitutionality of the ACA's individual mandate, which requires most people to maintain a minimum level of health insurance coverage beginning in 2014. A majority of the Court also found the ACA's Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied…

  • The Role of Medicaid for Adults With Chronic Illnesses

    Fact Sheet

    This report and related fact sheets provide data on spending, utilization, and access to care among low-income nonelderly adult Medicaid beneficiaries with chronic illnesses. Four fact sheets provide detail for beneficiaries with diabetes, respiratory disease, cardiovascular disease, and behavioral health conditions The reports show that, despite relatively high prevalence of chronic conditions and, correspondingly, relatively high spending and utilization rates, Medicaid beneficiaries with chronic illness report better access to care than their uninsured counterparts, many…

  • The Public’s Health Care Agenda for the New Congress and Presidential Campaign, December 2006

    Poll Finding

    This Kaiser Family Foundation/Harvard School of Public Health National Survey looks at the public's priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It focuses, in particular, on differences and similarities among Democrats, Republicans, and those who identify themselves as Independents or something else. The poll, conducted November 9-19, 2006, by the Kaiser Family Foundation and the Harvard…

  • Resuming the Path to Health Coverage for Children and Parents: A 50-State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2006

    Poll Finding

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children’s Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

  • New Study Shows Medicaid Spending Growth Can Be Sustained By Expected Increases in Government Revenues

    Event Date:
    Event

    A new study from the Foundation's Kaiser Commission on Medicaid and the Uninsured, published in Health Affairs, concludes that expected growth in government revenues is likely to be large enough to sustain Medicaid spending increases over the next 40 years, while also allowing substantial real growth in spending for other public services. The study projects that Medicaid's share of national health spending will remain virtually unchanged until 2025 and then increase slowly by 2045. News…

  • Giving Voice to the People of New Orleans: The Kaiser Post-Katrina Baseline Survey

    Poll Finding

    This house-to-house survey of people living in the New Orleans area examines the ongoing struggles of residents seeking to recover from the Hurricane Katrina disaster, including a detailed look at differences in views and experiences by race. Designed and analyzed by researchers at the Kaiser Family Foundation, the survey provides a portrait of the enormous needs of the population in order to inform recovery efforts and policy development on the Gulf Coast and in Washington.…

  • Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States

    Report

    Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States Medicaid consumer direction of personal assistance services (CD-PAS) is a growing trend. Although overall enrollment in these programs is small, 42 states offered consumer direction in Medicaid in 2006. These programs allow Medicaid beneficiaries control over hiring, scheduling, training and paying of personal care attendants. This report is based focus groups with enrollees in CD-PAS programs in the four states…

  • Medicaid in a Declining Economy:  Limited Approaches for States to Control Spending

    Issue Brief

    Medicaid in a Declining Economy: Limited Approaches for States to Control Spending This brief analyzes results from its annual 50-state budget surveys of Medicaid directors from 2003 to 2007. The historical results describe how states adopted a wide array of Medicaid cost containment strategies during the last economic downturn and were assisted by the federal government to avoid deeper Medicaid cuts. Issue Brief (.pdf) See related material on this issue