Medicaid

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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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  • What Difference Does Medicaid Make? Assessing Cost Effectiveness, Access, and Financial Protection under Medicaid for Low-Income Adults

    Issue Brief

    This brief examines the cost and use of health care among low-income nonelderly adults who are covered by Medicaid relative to their expected service use and costs if they instead had employer-sponsored insurance (ESI) coverage or were uninsured. The analysis controls for a wide array of factors that also influence utilization and spending in an effort to isolate the specific effects of Medicaid coverage. Consistent with previous research, the analysis underscores how Medicaid facilitates access…

  • Medicaid Expansion Briefing: What’s at Stake for States?

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    Event

    The Alliance for Health Reform and the Kaiser Family Foundation present a November 30 briefing to discuss the Medicaid expansion and what's at stake for states. Speakers address questions around the potential financial impact of the expansion on states, the role of the federal government in financing the expansion, and what it might mean for providers on the ground level, as well as the effect on the safety net population should states choose to opt…

  • Getting into Gear for 2014: Briefing, Survey Examine 2013 Data From 50-State Survey of Medicaid and CHIP Eligibility and Enrollment Policies

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    Event

    Following the Supreme Court ruling upholding the Affordable Care Act (ACA) and as 2014 approaches, many states are moving into high gear to prepare for implementation of the major provisions of the law, including a new streamlined Medicaid enrollment system and, at states' option, the expansion of Medicaid. Nearly all states are pressing forward with information technology and process improvements to develop faster, streamlined Medicaid enrollment systems as required under the ACA, whether or not…

  • Case Study: Michigan’s Money Follows the Person Demonstration

    Report

    This case study looks at Michigan's Money Follows the Person (MFP) demonstration program, which has enabled the state to accelerate existing transition activities and increase access to home- and community-based services (HCBS) by providing enhanced federal funds for each MFP participant’s 365-day enrollment period. Through MFP, Michigan is able to provide a comprehensive set of demonstration services in addition to existing HCBS waiver services so that each MFP participant receives the services necessary to transition…

  • Money Follows the Person: A 2012 Survey of Transitions, Services and Costs

    Issue Brief

    The Affordable Care Act extended the Money Follows the Person (MFP) demonstration grant program through 2016, giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. A total of 45 states…

  • Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010

    Feature

    Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010 Download Source KCMU and Urban Institute estimates based on FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 data. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

  • Medicaid Enrollment: June 2011 Data Snapshot

    Issue Brief

    This snapshot finds that between June 2010 and June 2011, while enrollment continued to grow as an additional 2.2 million people enrolled in Medicaid programs nationally, enrollment growth in the program slowed as the economy started to improve. Enrollment growth over this period was 4.4 percent, down significantly each of the two prior annual periods. Since June 2007, just before the start of the recession, Medicaid enrollment has grown by over 10 million people, over…

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy…