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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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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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  • The ‘Private Option’ Medicaid Expansion in Arkansas Has Helped Reduce the Uninsured Rate and Uncompensated Care Costs While Boosting the State’s ACA Marketplace

    News Release

    A new issue brief from the Kaiser Family Foundation finds that Arkansas’ “private option” Medicaid expansion has helped reduce the number of uninsured and bring down uncompensated care costs while strengthening the state’s ACA marketplace. A Look at the Private Option in Arkansas draws upon early data as well as interviews conducted in spring 2015 with state officials, providers, insurance carriers, and consumer advocates to provide an initial look how implementation of the private option…

  • Medicaid’s Role in Alaska

    Fact Sheet

    This fact sheet provides data on Medicaid's role in Alaska. It describes how ending the enhanced match for Medicaid expansion and implementing a per capita cap or block grant would affect Alaska.

  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…

  • Medicaid Medically Needy Programs: An Important Source of Medicaid Coverage

    Issue Brief

    This issue brief provides an overview of Medicaid's medically needy program; describes how it works for persons with disabilities, the elderly, and low-income families; and highlights some key issues surrounding the program. Included in the paper are hypothetical examples of ways in which individuals can qualify for the medically needy program and are intended for illustrative purposes only.

  • Children’s Health Coverage – What You Need To Know

    Event Date:
    Event

    On Monday, July 14, 2014, the Kaiser Family Foundation and the Alliance for Health Reform will host a briefing to discuss CHIP, and why it was created, as well as experiences with children’s coverage through CHIP and Medicaid, and some of the key policy and financing questions around children’s health coverage looking forward.

  • Health Coverage for Low-Income Americans:  An Evidence-Based Approach to Public Policy

    Report

    Health Coverage for Low-Income Americans: An Evidence-Based Approach to Public Policy This report offers an evidence-based framework for developing public policy approaches to covering low-income Americans. The first part of the report is devoted to the question: What is the role for publicly sponsored health insurance? The second part turns to seven central issues in structuring a publicly sponsored health insurance program for the low-income population. The report outlines each of these issues, provides a…

  • Five Key Questions And Answers About Section 1115 Medicaid Waivers

    Issue Brief

    This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. For many years, Section 1115 waivers have been used by states to test new coverage approaches not otherwise allowed under Medicaid program rules. Some waivers have also raised important policy issues. Since the passage of the health reform law, several states, including California,…