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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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  • Estimating Federal Payments and Eligibility for Basic Health Programs: An Illustrative Example

    Report

    In some states, policymakers and stakeholders are considering adoption of the Basic Health Program (BHP) option permitted under the Patient Protection and Affordable Care Act (ACA). Federal regulations allow BHP implementation beginning in 2015. Through BHP, consumers with incomes at or below 200 percent of the federal poverty level (FPL) who would otherwise qualify for subsidized qualified health plans (QHPs) offered in health insurance marketplaces instead are offered state-contracting standard health plans that provide coverage…

  • Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

    Report

    This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation's Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and…

  • What Drives Spending and Utilization on Medicaid Drug Benefits in States?

    Issue Brief

    With the approval of new specialty drugs, such as the Hepatitis C treatments Sovaldi and Harvoni, states are mindful that the cost the Medicaid prescription drug benefit could increase. To achieve savings, and improve management and health outcomes, it is important to understand which drugs are most frequently prescribed and which drive spending. Using state drug utilization data provided through the Medicaid Drug Rebate Program, as well as an industry drug database, this issue brief…

  • Tapping Nurse Practitioners to Meet Rising Demand for Primary Care

    Issue Brief

    More than 58 million Americans, or nearly 1 in 5, live in primary care shortage areas, where the supply of primary care physicians is not sufficient to meet the needs of the population. Particularly as the demand for primary care increases due to population growth, aging, and expanded insurance coverage, strategies to mitigate already sharp strains on primary care capacity are needed. This brief focuses on the opportunity to more fully tap the potential of…

  • May Kaiser Health Tracking Poll: Views of Health Reform Law Remain Unchanged

    Perspective

    This month’s Kaiser Health Tracking Poll reveals little change in public opinion about the health reform law. Americans remain divided overall, with 42 percent having a favorable opinion of the law and 44 percent viewing it unfavorably. Three in ten continue to want to see the law expanded, while roughly one in five want it either kept as is (21%), repealed and replaced with a GOP alternative (19%), or repealed outright (19%). Americans continue to…

  • Betting on Private Insurers

    Perspective

    Just-released estimates of national health spending in 2010 by the Centers for Medicare and Medicaid Services (CMS) show that 45% of our health care spending is financed by the federal and state governments, primarily through the Medicare and Medicaid programs. This share has grown temporarily in recent years because of the economic downturn, as private insurance has declined and Medicaid has grown. It has also increased due to our demographic destiny: the growing cohort of baby…

  • KFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision

    Perspective

    As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether the law overall will leave their own families better off (26 percent), worse off (33 percent), or if it won’t make much difference (34 percent).…

  • How the ACA Changes Pathways to Insurance Coverage for People with HIV

    Perspective

    There are multiple sources of insurance coverage and care for people with HIV in the United States.  These include public programs, such as Medicaid and Medicare, and the Ryan White HIV/AIDS program, as well as private coverage through an employer or in the individual market. Medicaid, the nation's principal safety-net health insurance program for low-income Americans, is estimated to cover the largest share of people with HIV. Fewer are covered by Medicare, the federal health…

  • Importance Of Medicaid To Own Family Varies By Household Income

    Feature

    Importance Of Medicaid To Own Family Varies By Household Income Download Source Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health, The Public’s Health Care Agenda for the 113th Congress (conducted January 3-9, 2013)