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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.

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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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  • Getting into Gear for 2014: Briefing, Survey Examine 2013 Data From 50-State Survey of Medicaid and CHIP Eligibility and Enrollment Policies

    Event Date:
    Event

    Following the Supreme Court ruling upholding the Affordable Care Act (ACA) and as 2014 approaches, many states are moving into high gear to prepare for implementation of the major provisions of the law, including a new streamlined Medicaid enrollment system and, at states' option, the expansion of Medicaid. Nearly all states are pressing forward with information technology and process improvements to develop faster, streamlined Medicaid enrollment systems as required under the ACA, whether or not…

  • Massachusetts and Ohio: Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

    Fact Sheet

    The Centers for Medicare and Medicaid Services (CMS) has finalized memoranda of understanding (MOUs) with Massachusetts and Ohio to test a capitated financial alignment model to integrate care and align financing for people who are dually eligible for Medicare and Medicaid in 2013. CMS also has signed an MOU with Washington to test a managed fee-for-service model. These three year demonstrations will introduce changes in the care delivery systems through which beneficiaries presently receive services…

  • Implementation of Affordable Care Act Provisions to Improve Nursing Home Transparency, Care Quality, and Abuse Prevention

    Report

    The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement. Despite the 1987 reforms, beginning in 1997, the Government Accountability Office issued more than 20 reports documenting serious quality of care problems in nursing homes…

  • Faces of the Medicaid Expansion: How Obtaining Medicaid Coverage Impacts Low-Income Adults

    Report

    The Affordable Care Act (ACA) seeks to fill the longstanding gap in Medicaid coverage for low-income adults by expanding eligibility to a minimum floor of 138% of the federal poverty level (FPL), or $24,344 for a family of 3 in 2012. However, the Supreme Court ruling on the ACA effectively made implementation of the Medicaid expansion a state choice. If a state does not expand Medicaid, poor uninsured adults in that state will not gain…

  • Case Study: Michigan’s Money Follows the Person Demonstration

    Report

    This case study looks at Michigan's Money Follows the Person (MFP) demonstration program, which has enabled the state to accelerate existing transition activities and increase access to home- and community-based services (HCBS) by providing enhanced federal funds for each MFP participant’s 365-day enrollment period. Through MFP, Michigan is able to provide a comprehensive set of demonstration services in addition to existing HCBS waiver services so that each MFP participant receives the services necessary to transition…

  • Roads to Community Living: A Closer Look at Washington State’s Money Follows the Person Demonstration

    Report

    This case study looks at Washington state's Money Follows the Person demonstration program, Roads to Community Living. The program is responsible for assisting over 2,400 Medicaid beneficiaries with complex long-term services and supports (LTSS) needs in transitioning out of institutions back to community-based care settings. Washington State has been a leader in Medicaid LTSS rebalancing efforts over the last two decades. According to the state, in the early 1990s, 82 percent of long-term care funding…

  • A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey

    Report

    Most Medicaid beneficiaries nationally are enrolled in some form of managed care, and, with current budget pressure and health reform on the horizon, states are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey, conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access…

  • Money Follows the Person: A 2012 Survey of Transitions, Services and Costs

    Issue Brief

    The Affordable Care Act extended the Money Follows the Person (MFP) demonstration grant program through 2016, giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. A total of 45 states…

  • States Sustain and Expand Coverage For Low-Income Children and Families Despite Recession, But Gains Are Threatened By Impending End of Federal Assistance

    News Release

    New 50-State Survey Illustrates Key Role of CHIP Reauthorization and the Federal Stimulus Law in Safeguarding Coverage    WASHINGTON  – Despite the deep recession, most states have managed to safeguard and, in some cases, expand health coverage for children and parents in their Medicaid and Children's Health Insurance Programs in 2009, according to a new survey from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured.  But the gains, which could serve as a…

  • Filling In The Long-Term Care Gaps

    Event Date:
    Event

    At a June 3 hearing of the Senate Special Committee on Aging, Diane Rowland, Executive Vice President of the Kaiser Family Foundation and Executive Director on the Kaiser Commission on Medicaid and the Uninsured, testified on the key challenges to providing a larger role for private long-term care insurance in financing long-term care for the elderly and people with disabilities. Her testimony coincided with the release of a policy brief on long-term care financing by…