Medicaid

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.

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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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  • Explaining Stewart v. Azar: Implications of the Court’s Decision on Kentucky’s Medicaid Waiver

    Issue Brief

    This issue brief summarizes the DC federal district court's June 29, 2018 decision in Stewart v. Azar, the lawsuit brought by Medicaid enrollees challenging the HHS Secretary’s approval of the Kentucky HEALTH Section 1115 waiver program, which includes a work requirement, premiums, coverage lockouts, and other provisions that the state estimated would lead 95,000 people to lose coverage.

  • New Analysis Illustrates Potential Impact of Medicaid Work Requirements on Coverage if Implemented Nationally as Called for by House Budget Committee and Senate Legislation

    News Release

    As a number of states pursue Medicaid waivers to require certain beneficiaries to work in order to receive benefits, the House Budget Committee passed a budget resolution this month calling for the enactment of Medicaid work requirements in all states, a goal also advanced in proposed legislation in the Senate by Sen. John Kennedy of Louisiana. Although details are scant at this point, a new analysis from the Kaiser Family Foundation provides illustrative scenarios of…

  • Implications of a Medicaid Work Requirement: National Estimates of Potential Coverage Losses

    Issue Brief

    A number of states have received approval for, have applied for, or are considering Medicaid waiver proposals that would impose work requirements as a condition of eligibility, and some policymakers are calling for a federal requirement that all states implement work requirements in Medicaid. This analysis provides illustrative scenarios of potential nationwide reductions in Medicaid coverage if all states implemented work requirements similar to those currently proposed. The scenarios assume low and high disenrollment rates…

  • KFF/EHF Poll: Texans’ Top State Health Priorities Include Lowering Out-of-Pocket Costs and Reducing Maternal Mortality

    News Release

    Most Texans Don’t Know their State has the Nation’s Highest Uninsured Rate Texans’ top health care priorities for the state revolve around making health care and prescription drugs more affordable, reducing maternal mortality and increasing access to health insurance coverage, finds a new statewide Kaiser Family Foundation/Episcopal Health Foundation survey on Texas health policy issues. Majorities say “top priority” should be given to lowering what people pay for health care (61%), reducing maternal mortality (59%),…

  • Texas Residents’ Views on State and National Health Policy Priorities

    Report

    As part of the new Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texans’ views on health policy priorities at both the state and national level. It examines how Texas residents view state spending on health care and how they rank initiatives such as lowering health care costs, reducing maternal mortality, and funding for mental health care. It also explores Texans’ views on the Affordable Care Act and Medicaid, including…

  • 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…