Medicaid

Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies.

A Closer Look at the Work Requirement Provisions in the 2025 Federal Budget Reconciliation Law

This issue brief provides an overview of the work requirement provisions included in the budget reconciliation law, including timelines, state flexibilities, and more.

Most Adults Subject to Work Requirements Work or Face Barriers

This analysis looks at the share of adults who work at least 80 hours per month, the reasons some do not, and how consistently individuals meet work requirements.

2025-2026 Medicaid Budget Survey

A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes

This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.

Medicaid Enrollment and Spending Growth: Fiscal Years 2025 and 2026

State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes

Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.

Drew Altman: Why Most States Will Not Replace Federal Medicaid Cuts

5 Key Facts About Medicaid and Provider Taxes

Challenges with Implementing Work Requirements

Eligibility, Enrollment, and Renewal Policies
KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
Seniors and People with Disabilities
More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
Children with Special Needs
Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
People With Intellectual and Developmental Disabilities
Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
Adults with Chronic Conditions
Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

The Essentials

5 Facts: Immigrants and Medicaid
This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.
5 Facts: Medicaid and Hospitals
This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.
Medicaid Financing: The Basics
Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.
5 Facts: Medicaid’s Share of National Health Spending
This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.
5 Facts: Medicaid and Nursing Facilities
The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.