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5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

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 and work

Tracking 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 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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  • Spending and Utilization of EpiPen within Medicaid

    Issue Brief

    Medicaid is also a major provider of EpiPen and has been impacted by its increasing price. In this Data Note, we examine utilization, spending before rebates, and spending per prescription of EpiPen and other epinephrine auto-injectors before rebates in the Medicaid program.

  • Data Note: Effect of State Decisions on State Risk Scores

    Issue Brief

    To gauge whether individual market risk pools are healthier in states that have expanded Medicaid and did not allow transitional plans, this data note compares average state risk scores using data from the Centers for Medicare & Medicaid Services Summary Report on Risk Adjustment for the 2015 benefit year. The analysis finds that states that expanded Medicaid and did not allow transitional plans had lower average risk scores, suggesting the risk pools in those state’s markets are healthier than in non-expansion states and in states that allowed transitional plans.

  • Snapshot of Where Hillary Clinton and Donald Trump Stand on Seven Health Care Issues

    Issue Brief

    Where do the 2016 Presidential candidates, Hillary Clinton and Donald Trump, stand on key health care issues? This snapshot outlines the candidates' positions and policy statements on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, women's reproductive health, and Zika.

  • Puerto Rico: Medicaid, Fiscal Issues and the Zika Challenge

    Fact Sheet

    Roughly one in two Puerto Ricans (49%) are enrolled in the island’s Medicaid program. This fact sheet provides an overview of the Medicaid program in Puerto Rico and emerging fiscal issues facing its health care system as Zika cases on the island continue to mount.

  • 8 Questions & Answers about Puerto Rico

    Fact Sheet

    These slides provide a quick snapshot of Puerto Rico’s population, as well as current and upcoming issues that are impacting the island’s health care system.

  • CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio

    Fact Sheet

    This fact sheet discusses CMS's denial of Ohio's proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state's Section 1115 demonstration waiver application.

  • Findings from the Field: Medicaid Delivery Systems and Access to Care in Four States in Year Three of the ACA

    Issue Brief

    Based on case studies and focus groups, this brief reviews delivery systems and access to care for Medicaid enrollees in Colorado, Connecticut, Kentucky, and Washington as of Spring 2016. The findings provide an on-the-ground view of Medicaid delivery systems and enrollees’ experiences accessing care three years after implementation of the Medicaid expansion. This brief builds on previous reports that examined states’ preparation for implementation prior to the initial ACA open enrollment period and their experiences after completion of the first and second open enrollment periods.

  • Findings from the Field: Enrollment and Consumer Assistance in Four States in Year Three of the ACA

    Issue Brief

    Based on case studies and focus groups, this brief reviews experiences with Medicaid and Marketplace enrollment, renewal, and consumer assistance in Colorado, Connecticut, Kentucky, and Washington as of Spring 2016. These states implemented the Medicaid expansion and established a state-based Marketplace (SBM) in 2014. This brief builds on previous reports that examined states’ preparation for implementation prior to the initial ACA open enrollment period and their experiences after completion of the first and second open enrollment periods.