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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

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.

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.

Dual Eligibles

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  • Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people with disabilities new information to help them get the most from these programs. Full PDF Report (.pdf) Section 1: Introduction HTML PDF Section 2: Medicare HTML PDF Section 3: Medicaid HTML PDF Section 4: Interaction Between Medicare and Medicaid HTML PDF

  • Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation

    Issue Brief

    Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)

  • The Basics of Medicare and Medicaid

    Issue Brief

    Together, Medicare and Medicaid provide health coverage to about 90 million Americans. To help explain the two programs, the Kaiser Family Foundation issued a new primer on the Medicare program and an updated version of its primer on the Medicaid program. Prepared by Kaiser staff, the primers provide an overview of the programs, who they serve, how the programs work and how they are financed. Medicare: A Primer Medicaid: A Primer

  • Who Are Direct Care Workers and How Might Federal Policy Changes Impact the Workforce?

    Issue Brief

    This analysis uses the 2024 American Community Survey (ACS) to provide an overview of demographic and socioeconomic characteristics of the direct care workforce, including home health aides, personal care aides, and nursing assistants who work in nursing facilities, residential care facilities, home health, and settings that provide nonresidential services for older adults and younger adults with disabilities.

  • Long-Term Service and Supports: The Future Role and Challenges for Medicaid

    Report

    This report examines the structure and impact of Medicaid’s role in long-term care. Based on a roundtable discussion of policy makers and experts and drawn from a body of health services research, the report highlights policy challenges facing the Medicaid program today and identifies issues in providing long-term care going forward. By gathering evidence to address key policy issues, such as integrating services, benefit design, quality monitoring and financing, the report can serve as a…

  • Health Coverage for Children and Families in Medicaid and SCHIP:  State Efforts Face New Hurdles

    Report

    Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles The seventh annual 50-state survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and SCHIP for children and families reports that nearly two-thirds of states expanded access to Medicaid and SCHIP between July 2006 and January 2008. Executive Summary (.pdf) Report (.pdf)

  • Briefing – A Foundation for Health Reform: Findings of An Annual 50-State Survey of Eligibility Rules, Enrollment and Renewal Procedures and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents During 2009

    Report

    In 2009, despite the bleakest economic picture in years, states managed to safeguard and in some cases expand health coverage for children and parents in their Medicaid and Children's Health Insurance Programs, according to the Kaiser Family Foundation's annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost-sharing Practices. That was in large part due to the substantial help that states received through the congressional reauthorization of CHIP and the…

  • Medicaid: A Primer on the Federal-State Partnership

    Event Date:
    Event

    This briefing provided an overview of the Medicaid program and its role in the health care system. Panelists discussed who is eligible for Medicaid, what benefits are covered, how the program is administered. Medicaid financing and the program’s role in health reform was also explained. More information on Medicaid from the Kaiser Family Foundation can be found in the related documents below. This March 4 briefing was cosponsored by the Kaiser Family Foundation and the…

  • A Primer on Dually Eligible Beneficiaries

    Event Date:
    Event

    The nine million dually eligible beneficiaries are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of Medicare and Medicaid spending. Because they often have complex medical and long-term care needs, and must navigate both Medicaid and Medicare benefits and financing, they present a special challenge for those seeking a more efficient and coordinated care delivery system. The panel will address such…

  • Provider Payment And Access To Medicaid Services: A Summary of CMS’ May 6 Proposed Rule

    Issue Brief

    This brief summarizes the major provisions of a rule proposed by the Centers for Medicare and Medicaid Services that would set forth state requirements for ensuring access to care in state Medicaid programs. It would apply to fee-for-service Medicaid, but not to Medicaid managed care programs. The public comment period for the regulation closed on July 5, 2011. Under the proposed rule, state Medicaid agencies would have to review access to a subset of Medicaid-covered…