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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.

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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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  • Medicaid Budgets, Spending and Policy Initiatives in State Fiscal Years 2005 and 2006

    Poll Finding

    The 50-state annual survey of about budget conditions and Medicaid cost containment actions in FY2005-06 shows that all states implemented and planned more Medicaid cost-containment actions, but are also implementing expansions as the gap between Medicaid spending growth and state tax revenue narrowed. Report (.pdf) Executive Summary (.pdf)

  • Medicaid: Overview and Impact of New Regulations

    Issue Brief

    In the past year the Bush Administration has moved forward with significant changes to the Medicaid program via rule-making. Taken together, six new regulations could result in an estimated $12 billion reduction in federal Medicaid spending over the next five years according to the regulatory impact statements prepared by Centers for Medicare and Medicaid Services. This brief focuses on the six new regulations that have been the source of considerable controversy and explains current policy,…

  • New Reports Examine Consumer Direction for Personal Assistance Services in Four States’ Medicaid Programs

    Report

    With a shift towards providing long-term services and supports in the community, policy interest in Medicaid consumer direction of personal assistance services (CD-PAS) has grown. Although overall enrollment in these programs is small, 42 states offered consumer direction in Medicaid in 2006. These programs allow Medicaid beneficiaries control over hiring, scheduling, training and paying of personal care attendants. The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured has produced two new reports examining Medicaid’s…

  • CHIP TIPS: Citizenship Documentation Changes

    Issue Brief

    This brief, the third in a series, examines changes to citizenship documentation requirements under the Children's Health Insurance Program Reauthorization Act of 2009. The law extends the requirement to document citizenship that applied in Medicaid to CHIP as well. At the same time, it modifies current requirements to reduce the paperwork burden on families and states and helps ensure that eligible children and others are enrolled and receive needed health care without delay. Brief (.pdf)

  • More Than Meets the Eye: Long-Term Care Provisions in the New Reform Law

    Event Date:
    Event

    In the debates around the health reform law and its implementation, little attention has been given to the law's provisions supporting long-term care. This briefing offered an overview of these provisions, such as the CLASS Act, a new national, voluntary insurance program to help working adults finance services and supports that they may need in the future, and the Community First Choice Option, which helps Medicaid recipients get attendant care at home. This October 1…

  • Medicaid and HIV: A National Analysis

    Report

    This report considers Medicaid’s current role in providing health coverage for people with HIV. It analyzes national enrollment and spending patterns for Medicaid enrollees with HIV, looking at key demographics, Medicaid eligibility pathways, services and geographic distribution. It also compares Medicaid enrollees with HIV to their counterparts without the disease, as well as to the population of people living with HIV in the U.S. The report finds that while Medicaid enrollees with HIV represent less…

  • Disability, Health Coverage, and Welfare Reform

    Report

    This report analyzes data from a survey of 42 low-income families with children with moderate or severe disabilities to better understand the impact of welfare reform on health coverage for these families. Report

  • Nearly a Quarter of People Who Say They Were Disenrolled from Medicaid During the Unwinding Are Now Uninsured   

    News Release

    Nearly a quarter (23%) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now, finds a new KFF national survey examining how the unwinding affected enrollees.  Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured, while 30% already had another form…

  • The Vast Majority of Nursing Facilities Will Need to Hire More Staff to Comply with the Final Federal Rule When Fully Implemented, Unless They Qualify for an Exemption

    News Release

    Based on a new KFF analysis, fewer than 1 in 5 (19%) nursing facilities currently meet the minimum staffing standards set out in the final requirements of the federal rule released today by the Centers for Medicare and Medicaid Services (CMS). CMS adopted staffing standards that are similar to the staffing requirements in the rule proposed last year, which included minimum staff levels of 0.55 registered nurses and 2.45 nurse aide hours per resident day.…