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Medicaid work requirements

Tracking the 2025 Reconciliation Law’s 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.

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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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  • Resuming the Path to Health Coverage for Children and Parents: A 50-State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2006

    Poll Finding

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children’s Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

  • Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States

    Report

    Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States Medicaid consumer direction of personal assistance services (CD-PAS) is a growing trend. Although overall enrollment in these programs is small, 42 states offered consumer direction in Medicaid in 2006. These programs allow Medicaid beneficiaries control over hiring, scheduling, training and paying of personal care attendants. This report is based focus groups with enrollees in CD-PAS programs in the four states…

  • Medicaid in a Declining Economy:  Limited Approaches for States to Control Spending

    Issue Brief

    Medicaid in a Declining Economy: Limited Approaches for States to Control Spending This brief analyzes results from its annual 50-state budget surveys of Medicaid directors from 2003 to 2007. The historical results describe how states adopted a wide array of Medicaid cost containment strategies during the last economic downturn and were assisted by the federal government to avoid deeper Medicaid cuts. Issue Brief (.pdf) See related material on this issue

  • Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year

    Report

    Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to expand access to community-based services and extend some services to a "moderate need" group for the first time to test the theory that early interventions…

  • Reports Analyze Cost and Coverage of People Eligible for Both Medicaid and Medicare and Options for Reforming Financing of Their Care

    Issue Brief

    These issue briefs examine coverage of the nearly 9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The reports explore the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, and provide state-level Medicaid spending and enrollment data related to this population. The policy options studied could collectively provide tens of billions of dollars in annual…

  • Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

    Issue Brief

    This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.

  • Medicaid Financing Issues: Provider Taxes

    Fact Sheet

    Current law allows states to use revenue from provider taxes to help fund the state share of spending on Medicaid, a program that is jointly financed by the states and the federal government. Almost all states have at least one provider tax in place. This issue brief reviews the use of provider taxes by states as a mechanism for financing the state share of Medicaid spending. It also explores the implications of recent proposed changes…

  • Update: State Budgets in Recession and Recovery

    Issue Brief

    State revenues have been rebounding after experiencing a severe decline caused by the Great Recession that ran from December 2007 through June 2009. Nevertheless, tax collections remain below their 2008 peak level and state and local governments continue to shed jobs. As states prepare their fiscal year 2013 budgets, some are projecting a fifth consecutive year of gaps between expected revenues and spending. This policy brief analyzes recent developments in state government finances and prospects…

  • Assessing the Role of Recent Waivers in Providing New Coverage

    Issue Brief

    This analysis finds that recent waivers have expanded coverage in important ways in a few states, but, overall, the number of people who have gained new coverage under recent waivers has been quite limited, well below projections and small compared to overall growth in Medicaid enrollment. Issue Paper (.pdf)