Medicaid

new and noteworthy

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 Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid Work Requirements

Tracking Medicaid Work Requirements: u003cbru003eData 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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

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.

Waiting Lists for Medicaid Home Care, 2016 to 2025
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.

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.

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  • Most States Would Have Seen Declines in Federal Medicaid Funds from 2001 to 2011 Under a Per Enrollee Spending Cap Limiting Growth to Medical Inflation

    News Release

    A new analysis from the Kaiser Family Foundation finds that the majority of states would have gotten less in federal Medicaid funding from 2001 to 2011 if Medicaid financing had been based on a per capita cap. The analysis looked at what would have happened if spending growth per Medicaid enrollee had been limited to growth in the medical care component of the Consumer Price Index (CPI-M) during that period. This spending growth limit is…

  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

  • Data Note: Three Findings about Access to Care and Health Outcomes in Medicaid

    Issue Brief

    The Medicaid program covers 74 million low-income Americans, including many of the poorest and sickest people in our society. Among those served are pregnant women and children, parents and other adults, poor seniors, and people with disabilities. Given Medicaid’s major coverage role and the complex needs of the populations it covers, data and evidence on access to care and health outcomes in Medicaid are of key interest. Such an assessment is also important to ensure…

  • Data Note: What if Per Enrollee Medicaid Spending Growth Had Been Limited to CPI-M from 2001-2011?

    Issue Brief

    Congress is currently debating the American Health Care Act (AHCA), which would repeal and replace the Affordable Care Act (ACA) and also make substantial changes to the structure and financing of Medicaid. Among other provisions, the AHCA would use a per capita cap policy to cap federal funds to states for Medicaid. This data note examines what the implications of tying per enrollee growth to CPI-M would have been for the 2001-2011 period for federal…

  • 11 Million People on Medicare Are Also Covered by Medicaid. What Could Switching to a Medicaid Per Capita Cap Mean for Them?

    News Release

    A major structural change to Medicaid financing such as the per capita cap system called for under the American Health Care Act could have significant implications for the 11 million seniors and people with disabilities who are covered by both Medicare and Medicaid, according to a new brief by the Kaiser Family Foundation. One in five Medicare beneficiaries relies on Medicaid for premium and cost-sharing assistance and to pay for services not covered by Medicare,…

  • Who Are the 7 Million Nonelderly Adults with Disabilities in Medicaid and What Would the House GOP Bill to Restructure Medicaid Financing and Repeal the Affordable Care Act Mean for Them?

    News Release

    A new brief from the Kaiser Family Foundation explains the role that Medicaid plays for nearly 7 million nonelderly adults with disabilities in the U.S. and explores what the American Health Care Act could mean for their health care and coverage. Medicaid covers more than three in 10 nonelderly adults with disabilities, including people with physical disabilities, such as cerebral palsy, multiple sclerosis, and traumatic brain or spinal cord injuries; intellectual or developmental disabilities such…

  • Restructuring Medicaid in the American Health Care Act: Five Key Considerations

    Issue Brief

    On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected…

  • The American Health Care Act: New House GOP Bill Summary and Interactive Maps of Its Effects on Tax Credits

    News Release

    The Kaiser Family Foundation today issued a summary of the Republican House leadership’s March 6 proposed Affordable Care Act (ACA) replacement bill, the American Health Care Act, that can be compared in 17 key policy areas to the ACA and several other proposed replacement plans. In addition, the Foundation updated its interactive maps that compare county-level estimates of premium tax credits consumers would receive under the Affordable Care Act (ACA) in 2020 with what they’d receive…

  • Views of Governors and Insurance Commissioners on ACA Repeal and Changes to Medicaid: Responses to a Congressional Request for State Input on Health Reform

    Issue Brief

    This brief summarizes responses from governors and insurance commissioners in 35 states, including DC, to a request from members in the House of Representatives for state input on health care reforms. These responses provide insight into state leaders’ views on repeal and replacement of the ACA and the changes Congress is considering making to the financing and structure of Medicaid. It finds that respondents have mixed views on the ACA and potential repeal and replacement…