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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.

Medicaid Budget Survey

Medicaid Home Care

Using data from the 23rd KFF survey of officials administering Medicaid home care programs, this issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect. The data come from KFF’s 23rd survey on Medicaid home care programs in all 50 states and DC.

KFF regularly surveys states about their Medicaid home- and community-based services (HCBS) programs and their eligibility policies for people who are eligible for Medicaid on the basis of having a disability or being 65 and older.

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This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.

Eligibility and coverage

  • 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.

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  • Where Is The Growth in the Uninsured Population Coming From?

    Other Post

    The Kaiser Commission on Medicaid and the Uninsured co-sponsored a policy briefing today to discuss the dynamics of the uninsured population in America. In 2001, the uninsured population grew by 1.4 million people.

  • Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues

    Report

    Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues While private long-term care insurance (LTCI) has been available since the mid-1970s, its popularity has grown rapidly in recent years, and Congress is considering proposals that would further encourage LTCI purchase through expanded tax subsidies.

  • Private Long-Term Care Insurance:  Who Should Buy It and What Should They Buy?

    Report

    Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy? Despite the growing interest in private long-term care insurance (LTCI), there has been little independent examination of how much protection LTCI policies provide consumers or whether LTCI policies are a worthwhile purchase for people of average means.

  • The Medicaid Resource Book

    Report

    This reference book describes four pivotal aspects of how the Medicaid program operates — who it covers, what it covers, how it is financed, and how it is administered. It was written to assist the public and policymakers in understanding the structure and operation of the Medicaid program.

  • Medicaid Medically Needy Programs: An Important Source of Medicaid Coverage

    Issue Brief

    This issue brief provides an overview of Medicaid's medically needy program; describes how it works for persons with disabilities, the elderly, and low-income families; and highlights some key issues surrounding the program. Included in the paper are hypothetical examples of ways in which individuals can qualify for the medically needy program and are intended for illustrative purposes only.

  • New Reports Explore State Implementation of Prescription Drug Prior Authorization

    Other Post

    States are grappling with a fiscal crisis that threatens funding for Medicaid, the federal-state partnership that provides health coverage for low-income populations. Two new studies shed light on the impact of an increasingly popular strategy - prior authorization - being used to control prescription drug spending.

  • Case Study:  Michigan’s Medicaid Prescription Drug Benefit

    Report

    Case Study: Michigan's Medicaid Prescription Drug Benefit This report describes the legislative process behind and content of Michigan's Pharmaceutical Product List (MPPL), a selection of preferred drugs available to be prescribed in the Medicaid program with little restriction.