Medicaid

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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.

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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  • Loss of the Affordable Care Act Would Widen Racial Disparities in Health Coverage

    Policy Watch

    In November, the Supreme Court is scheduled to hear arguments on a legal challenge that seeks to overturn the Affordable Care Act (ACA). This analysis shows that new coverage options under the ACA have contributed to large gains in coverage, particularly among people of color, helping to narrow longstanding racial disparities in health coverage.

  • A Court Ruling Striking Down the ACA Would Eliminate the Medicaid Expansion and Cause Millions of Low-Income People to Become Uninsured

    News Release

    Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November, KFF experts explain in a new Policy Watch post. Overturning the ACA would eliminate the expansion of Medicaid, which largely has been financed by the federal government, and eliminate eligibility for Medicaid for low-income…

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    From Drew Altman

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  • Federal Medicaid Outlays During the COVID-19 Pandemic

    Issue Brief

    This data note analyzes federal Medicaid outlays before and during the COVID-19 pandemic. In the one year since the onset of the pandemic, federal Medicaid outlays totaled $500.8 billion and grew by 19.5%, compared to 6.3% growth in the one year before the pandemic.

  • A Closer Look at the Courts’ Impact on Health Policy

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman maps what the combined impact of the Supreme Court decision on the Affordable Care Act’s Medicaid expansion and a plaintiff’s win in Halbig would look like and discusses the impact of court decisions on health policy.

  • One Year into Duals Demo Enrollment: Early Expectations Meet Reality

    Perspective

    One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

  • Provider Payment And Access To Medicaid Services: A Summary of CMS’ May 6 Proposed Rule

    Issue Brief

    This brief summarizes the major provisions of a rule proposed by the Centers for Medicare and Medicaid Services that would set forth state requirements for ensuring access to care in state Medicaid programs. It would apply to fee-for-service Medicaid, but not to Medicaid managed care programs. The public comment period for the regulation closed on July 5, 2011. Under the proposed rule, state Medicaid agencies would have to review access to a subset of Medicaid-covered…

  • States Focus on Cost Containment as a Loss of Federal Stimulus Funds Means State Costs for Medicaid Will Jump in FY 2012

    News Release

    NEWS RELEASEThursday, October 27, 2011 New 50-State Survey Finds Cuts In Provider Payments And Changes In Delivery Of Services WASHINGTON, D.C. - Faced with the end of stimulus money and a continuing weak economy, Medicaid officials in virtually every state are enacting a variety of cost cutting measures as states’ spending for Medicaid is projected to increase 28.7 percent this fiscal year to make up for the loss of federal funds, according to a new survey…