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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.

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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  • Only Six Percent of Adult Medicaid Enrollees Targeted by States’ New Work Requirements Are Not Already Working and Are Unlikely to Qualify for an Exemption

    News Release

    Among enrollees targeted in the push for work requirements for “able-bodied adults” in Medicaid, only 6 percent are not already working and unlikely to qualify for an exemption, according to an analysis from the Kaiser Family Foundation. Nationally, more than 6 in 10 nonelderly adults in Medicaid who do not receive federal disability or Medicare coverage are already working full-time (43%) or part-time (19%), the analysis finds. Nearly a third of nonelderly adults in Medicaid…

  • 33 States and DC Have Adopted Medicaid Expansion, as of May 2018

    Feature

    Source Current status for each state is based on KFF tracking and analysis of state executive activity. Also see the related State Health Facts page “Status of State Action on the Medicaid Expansion Decision” for additional details.

  • Implications of the ACA Medicaid Expansion: A Look at the Data and Evidence

    Issue Brief

    More than four years after the implementation of the Medicaid expansion included in the Affordable Care Act, debate and controversy around the implications of the expansion continue. Despite a large body of research that shows that the Medicaid expansion results in gains in coverage, improvements in access and financial security, and economic benefits for states and providers, some argue that the Medicaid expansion has broadened the program beyond its original intent diverting spending from the…

  • Research Shows That Medicaid Expansion Has Resulted in Coverage and Economic Gains Without Affecting Traditional Groups or Other State Programs

    News Release

    States that have expanded Medicaid under the Affordable Care Act generally have seen gains in coverage, improvements in access to and affordability of health care, and net fiscal benefits, a growing body of research and data show. At the same time, Medicaid expansion has not diverted coverage from traditional groups or significantly reduced state spending on other programs, the research shows, contrary to assertions by some critics of Medicaid expansion. For example, data do not…

  • Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

    Issue Brief

    Research demonstrates that improving population health and achieving health equity will require broad approaches that address social, economic, and environmental factors that influence health. This brief provides an overview of the broad factors that influence health and describes efforts to address them, including initiatives within Medicaid.

  • Atención de salud en Puerto Rico y las Islas Vírgenes de los Estados Unidos: una revisión, a seis meses de las tormentas (Informe)

    Issue Brief

    Puerto Rico y las Islas Vírgenes de los Estados Unidos (USVI) sufrieron daños significativos en su infraestructura y sistemas de salud a causa del impacto de los huracanes Irma y María en septiembre de 2017. Basándose en entrevistas con residentes, partes interesadas clave, y en informes públicos, este informe proporciona una visión general del estado de los esfuerzos de recuperación, a seis meses de las tormentas, con un enfoque en los sistemas de atención médica.

  • Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Report)

    Issue Brief

    Puerto Rico and the U.S. Virgin Islands suffered significant damage to their infrastructure and health care systems from Hurricanes Irma and Maria in September 2017. Drawing on interviews with residents and key stakeholders as well as public reports, this brief provides an overview of the status of the recovery efforts six months after the storms, with a focus on the health care systems.

  • Nearly 20 Million Children Live in Immigrant Families that Could Be Affected by Evolving Immigration Policies

    Issue Brief

    President Trump has intensified national debate about immigration by implementing policies to enhance immigration enforcement and restrict legal immigration. Recent findings show that the climate surrounding these policies has significantly increased fear and uncertainty among immigrant families, broadly affecting families across different immigration statuses and locations. The effects extend to lawfully present immigrants, including lawful permanent residents or “green card” holders, and children in immigrant families, who are predominantly U.S.-born citizens. In particular, findings point…

  • Medicaid’s Role for Selected Populations

    Feature

    Medicaid_s role for selected populations Download Source NOTE: FPL-- Federal Poverty Level. The U.S. Census Bureau's poverty threshold for a family with two adults and one child was $19,318 in 2016. SOURCES: KFF analysis of 2017 Current Population Survey, Annual Social and Economic Supplement; Birth data -Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017, KFF, October 2016.; Medicare data - Medicare Payment Advisory Commission,…