Medicaid

Medicaid work requirements

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

Event Date:

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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  • February State Data for Medicaid Work Requirements in Arkansas

    Issue Brief

    Arkansas is one of seven states for which CMS has approved a Section 1115 waiver to condition Medicaid eligibility on meeting work and reporting requirements and the first state to implement this type of waiver. The new requirements were phased in for most enrollees ages 30-49 beginning in June 2018, and for individuals ages 19-29 starting in January 2019. Unless exempt, enrollees must engage in 80 hours of work or other qualifying activities each month…

  • Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and…

  • A Comprehensive Review of Research Finds That the ACA Medicaid Expansion Has Reduced the Uninsured Rate and Uncompensated Care Costs in Expansion States, While Increasing Affordability and Access to Care and Producing State Budget Savings   

    News Release

      Multiple studies over the last five years find that the Affordable Care Act’s Medicaid expansion has increased health coverage, affordability, and access to care while producing budget savings for states and reductions in uncompensated care costs for hospitals and clinics, according to a KFF review of more than 300 studies and policy reports. Thirty-six states and the District of Columbia have adopted the ACA Medicaid expansion. The literature review provides a useful reference on…

  • Community Health Center Financing: The Role of Medicaid and Section 330 Grant Funding Explained

    Issue Brief

    This issue brief describes the two primary sources of health center revenue—Medicaid and Section 330 grant funding. The evolution of these funding streams has contributed to significant growth in the health center program, enabling expanded services to millions of additional residents of the nation’s most medically underserved rural and urban communities.

  • The Difference Different Approaches Make: Comparing Proposals to Expand Health Insurance

    Report

    The Difference Different Approaches Make: Comparing Proposals to Expand Health Insurance This paper estimates and compares the impacts of alternative mechanisms for expanding health insurance coverage. A variety of approaches-expansions of existing public programs, direct subsidies, and tax credits-and target populations-including children, poor adults, parents of Medicaid- or CHIP-covered children, and early retirees-are considered. The impacts of the proposals on coverage, costs and other program outcomes are compared. This paper is part of the Kaiser…

  • Low-Income and Uninsured: The Challenge for Extending Coverage

    Event Date:
    Event

    Diane Rowland, executive director of the Commission, testified to the Senate Committee on Finance about the low-income uninsured. The testimony provides a comprehensive description and analysis of the population and discusses the challenges of providing them health coverage. Please note: the video is no longer available.  If you have an urgent need for the video, you may contact us (choose “problem with video” on the form) and we will try to locate the video. Include the…

  • Overview of Medicaid Managed Care Provisions in the Balanced Budget Act of 1997 – Report

    Report

      Overview of Medicaid Managed Care Provisions in the Balanced Budget Act of 1997 Prepared by Andy SchneiderThe Center on Budget and Policy Priorities for The Kaiser Commission on the Future of Medicaid December 1997 This paper was prepared for The Kaiser Commission on the Future of Medicaid with support from The Henry J. Kaiser Family Foundation. The views represented in this report are those of the author and do not necessarily represent the views…

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…

  • New Study Shows Medicaid Spending Growth Can Be Sustained By Expected Increases in Government Revenues

    Event Date:
    Event

    A new study from the Foundation's Kaiser Commission on Medicaid and the Uninsured, published in Health Affairs, concludes that expected growth in government revenues is likely to be large enough to sustain Medicaid spending increases over the next 40 years, while also allowing substantial real growth in spending for other public services. The study projects that Medicaid's share of national health spending will remain virtually unchanged until 2025 and then increase slowly by 2045. News…

  • Health and the Economy in the Detroit Area

    Poll Finding

    One year after the federal government intervened to aid the automakers, the Foundation along with The Washington Post and Harvard School of Public Health surveyed the residents of the tri-county Detroit area of Macomb, Oakland, and Wayne Counties to ask about their views and experiences in the midst of the area’s economic meltdown. Using data from the comprehensive survey and other publicly available information, this data note provides an overview of the current economic and…