Medicaid

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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  • Long-Term Care:  Understanding Medicaid’s Role for the Elderly and Disabled

    Issue Brief

    Long-Term Care: Understanding Medicaid’s Role for the Elderly and Disabled This updated report provides a review of how Medicaid works for people with long-term care needs and describes the fiscal challenges that states currently face and that Medicaid may face in the future as the population ages. Report (.pdf) Executive Summary (.pdf)

  • New Kaiser Resources Examine Medicaid as a Platform for Health Reform

    Issue Brief

    These related research papers examine the policy opportunities for expanding Medicaid to cover more low-income and high-need people in ways that would enable the program to serve as a platform for larger national health reform efforts. As congressional leaders work on proposals for universal coverage, some policymakers have suggested that strengthening Medicaid’s coverage of the poorest Americans and those with special health needs could provide a base for broader health reform efforts to expand coverage,…

  • CHIP TIPS: CHIP Financing Structure

    Issue Brief

    This brief, the fourth in a series, examines important changes to CHIP’s financing structure under the Children’s Health Insurance Program Reauthorization Act of 2009. The law includes a number of important programmatic and financing changes that affect both Medicaid and CHIP. Among the most important changes include significant new funding for the CHIP program, changes in the formula for distributing CHIP funds among states and a new option for states to decide whether to use…

  • CHIP TIPS: Children’s Oral Health Benefits

    Issue Brief

    This brief examines a new requirement under the Children's Health Insurance Program Reauthorization Act of 2009 that state CHIP programs cover comprehensive dental benefits. The reauthorization law also allows states with separate CHIP programs to offer a dental-only plan for children who have other health insurance but lack adequate dental benefits. Other oral health improvements in the law include education for new parents, better access to benefit and provider information and enhanced reporting on the…

  • Special Needs Plans: Availability and Enrollment

    Report

    Special Needs Plans are a form of Medicare Advantage plan authorized to provide a managed care option for beneficiaries with significant or relatively specialized care needs, including Medicare beneficiaries who are dually eligible for Medicare and Medicaid, beneficiaries living in nursing homes or other institutions, and beneficiaries with severe chronic or disabling conditions. This data spotlight examines availability and enrollment trends for Special Needs Plans, which account for a small share of enrollment today but…

  • Medicaid and SCHIP Eligibility for Immigrants

    Fact Sheet

    Immigrants in the U.S. face increasing challenges securing health care coverage. They have less access to employer-sponsored insurance than native citizens and face tighter restrictions on their eligibility for Medicaid and SCHIP, the nation’s major public health coverage programs for low-income children and families. This fact sheet provides an overview of the current rules on immigrants' eligibility for Medicaid and the State Children's Health Insurance Program. Fact Sheet (.pdf)