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Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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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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  • The Role of Clinical and Cost Information in Medicaid Pharmacy Benefit Decisions: Experience in Seven States

    Issue Brief

    This policy brief provides perspective on the potential for using comparative effectiveness research in Medicaid pharmacy programs by looking at seven states to determine how they currently evaluate relative clinical and cost information about prescription drugs when making coverage decisions for their Medicaid pharmacy benefits. The brief was prepared by researchers at the Foundation's Kaiser Commission on Medicaid and the Uninsured and Avalere Health. Policy Brief (.pdf)

  • The Arizona KidsCare CHIP Enrollment Freeze: How Has It Impacted Enrollment and Families?

    Issue Brief

    This paper examines the impact on enrollment and families of Arizona's Dec. 21, 2009, decision to freeze enrollment in KidsCare, the state's Children's Health Insurance Program (CHIP). The CHIP enrollment freeze, enacted in response to recession-driven state budget pressures, saved the state $12.9 million in FY 2011, but has also resulted in more than 100,000 children being placed on a waiting list for coverage and the loss of $41 million in federal matching funds. Issue…

  • Managing Medicaid Pharmacy Benefits: Current Issues and Options

    Report

    This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs. The analysis, conducted by researchers from the Foundation's Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, focuses on the potential of several measures recently highlighted by Health and Human Services Secretary Kathleen Sebelius to reduce Medicaid pharmacy costs and is informed, in part, by the perspectives of a group of Medicaid pharmacy administrators convened by the Foundation in…

  • Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

    Issue Brief

    This brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those…

  • Managing Costs and Improving Care: Team-based Care of the Chronically Ill

    Event Date:
    Event

    Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs. This briefing, cosponsored by the Alliance for Health Reform and The Commonwealth Fund, looked at ways to improve the quality of care for the chronically ill while reducing the growth in spending for their care.…

  • Pulling It Together: Are We Headed for a Government Takeover of Health Care?

    Perspective

    Remember the “government takeover of the health care system” argument that critics of the health reform law have used?  Well, last week the Office of the Actuary in the Centers for Medicare and Medicaid Services published the latest projections of health spending in the journal Health Affairs.  Attention focused mainly on the Actuary’s estimate that national health spending would grow to almost 20% of GDP by 2020 and that the Affordable Care Act (ACA) would…

  • An Overview of Changes in the Federal Medical Assistance Percentages (FMAPs) for Medicaid

    Issue Brief

    The joint federal-state financing of the Medicaid program works through a matching mechanism known as the Federal Medical Assistance Percentage (FMAP). This mechanism determines the federal and state shares of Medicaid costs based on a state's per capita personal income relative to the national average. While the FMAP formula has remained unchanged since the enactment of the Medicaid program in 1965, changes in per capita income have resulted in substantial changes in the federal and…

  • Explaining Health Reform: Uses of Express Lane Strategies to Promote Participation in Coverage

    Issue Brief

    Under the Patient Protection and Affordable Care Act (ACA), millions of uninsured adults and children will gain eligibility for Medicaid or health coverage through new health insurance Exchanges beginning in 2014. The law calls upon states to develop simple and streamlined processes for establishing, verifying, and updating eligibility for Medicaid, the Children's Health Insurance Program and federal subsidies for Exchange coverage. This issue brief examines how states can employ "express lane" principles in designing systems…

  • 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…

  • Explaining Health Reform: The New Rules for Determining Income Under Medicaid in 2014

    Issue Brief

    To provide individuals and families access to affordable, high-quality health care, the Patient Protection and Affordable Care Act (ACA) expands Medicaid to cover low-income adults and children with incomes up to 133 percent of the poverty line. Millions of low-income parents, non-disabled adults who do not have dependent children (and who are generally ineligible for Medicaid today except in a small number of states) and, in some instances, children now covered through the Children’s Health…