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An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid Work Requirements

Tracking 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.

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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  • Two New Reports Show Progress On Health Coverage Is Threatened As States Continue To Face Growing Pressures To Control Costs

    Report

    Two New Reports Show Progress on Health Coverage is Threatened as States Continue to Face Growing Pressures to Control Costs Two new KCMU 50-state surveys show states continue to face budget pressures that could limit public coverage. One survey shows all states plan more Medicaid cost-containment actions in FY2005 and the second shows that after recent gains, securing Medicaid and SCHIP coverage is more difficult for low-income families in 23 states. News Release The Continuing…

  • Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations

    Issue Brief

    Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations The Kaiser Family Foundation has commissioned a series of papers to explore key issues that may be of concern for Medicare beneficiaries as the new Medicare drug benefit is implemented. These papers focus on specific areas of potential concern for people with Medicare. In addition, the Foundation also has produced a timeline of upcoming important dates leading up to the implementation of…

  • Views of the New Medicare Drug Law – Chartpack By Income Group

    Report

    This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, looking at key findings broken down by income group. Chartpack (.pdf)

  • Issues for Medicare Beneficiaries in Long-Term Care Facilities: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Vicki Gottlich, J.D., of the Center for Medicare Advocacy, looks at issues related to the new Medicare prescription drug benefit for people with Medicare who live in nursing homes or other long-term-care settings. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Building an On-Ramp to Children’s Health Coverage:  A Report on California’s Express Lane Eligibility Program

    Report

    Building an On-Ramp to Children's Health Coverage: A Report on California's Express Lane Eligibility Program This report documents the results from California’s Express Lane Eligibility (ELE) initiative through the school lunch program (now one year into implementation), which has been piloted in 72 schools in 5 school districts in the state. ELE is an enrollment strategy that targets large numbers of uninsured children, who are eligible for the federal-state programs Medicaid and SCHIP, where they…

  • States’ Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion

    Other Post

    States' Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion The Medicare Modernization Act (MMA) created a major new subsidy program for an estimated 14 million low-income Medicare beneficiaries that will provide assistance with their cost-sharing obligations under the Part D drug benefit. The MMA requires state Medicaid agencies, along with the Social Security Administration (SSA), to accept applications for the new low-income subsidy. MMA also specifies that people who…

  • Medicaid Disease Management: Issues and Promises

    Issue Brief

    This issue paper presents information from nine states that have developed and implemented disease management programs for adult Medicaid enrollees with chronic conditions such as asthma, diabetes, and congestive heart failure, or who are trying to manage these populations through capitated managed care. It examines the motivations, goals, strategies and impact of these state efforts, in addition to describing the details of their initiatives. Issue Paper (.pdf)

  • Health Care and the 2004 Elections

    Other Post

    ** Update: For information on health care and the 2008 election, visit www.health08.org. ** Health care issues continue to be important for many Americans and a vital part of the policy debates in Washington and around the country. During an election season, candidates propose and debate their solutions for the pressing policy issues facing their constituents. The 2004 election season is no different and the Kaiser Family Foundation is issuing informational materials on some of…