Medicaid

new and noteworthy

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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  • The Pennsylvania Health Care Landscape

    Fact Sheet

    The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Pennsylvania and elsewhere across the country. Pennsylvania is experiencing changes to its health care delivery system as the state expands Medicaid, provides new coverage options through the federal health insurance marketplace, streamlines application and enrollment processes for coverage programs, and implements new health care delivery system and payment reforms. This fact sheet provides an overview of population health, health coverage, and the health care delivery system in Pennsylvania in the era of health reform.

  • Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities

    Issue Brief

    This brief presents findings from focus groups with low-income Medicaid and Marketplace enrollees in six cities: Baltimore, MD; Columbus, OH; Oakland, CA; Richmond, VA; St. Louis, MO; and Tampa, FL. It explores their experiences signing up for coverage; their perceptions of whether the costs they pay for their coverage are affordable; their experiences accessing care; and the impact of out-of-pocket costs on their ability to get needed care. It provides insights into the ongoing financial struggles facing low-income individuals and the problems they confront affording health coverage.

  • Web Briefing – Serving the Homeless Community: New Findings on the Impact of the ACA Medicaid Expansion

    Event Date:
    Event

    On Tuesday, April 26, 2016, KFF presented a web briefing to examine new findings about how the Medicaid expansion has affected patients who are homeless, as well as the providers who care for them. The briefing addressed changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects, a subset of community health centers that serve individuals who are homeless, in both expansion and non-expansion states, as well as examined experiences in health centers that serve a broad low-income population.

  • What Paul Ryan’s Stance on 2016 Means for Health Care

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of Paul Ryan’s decision to rule out being drafted as a Republican presidential candidate for the 2017 health care agenda and how it could focus greater attention on proposals to change Medicare and Medicaid along with the Affordable Care Act.

  • Medicaid Spending Growth Compared to Other Payers: A Look at the Evidence

    Issue Brief

    A number of studies have demonstrated that Medicaid coverage helps to improve receipt of preventive health care, access to care, and out-of-pocket spending burdens and other financial outcomes. However, given ongoing concerns about federal and state budgets, the costs of the Medicaid program are likely to be again at the forefront of state and federal policy discussions. As federal policy makers consider proposals to reform Medicaid financing, this issue brief examines evidence from over 40 methodologically rigorous studies related to Medicaid spending.

  • The Affordable Care Act After Six Years

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do.

  • How has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs

    Issue Brief

    To further understand how the first full year of Medicaid expansion has affected patients who are homeless and the providers who care for them, this analysis uses data from the Uniform Data System (UDS) for health centers to examine changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects serving the homeless population.