Medicaid

new and noteworthy

An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid Work Requirements

Tracking Medicaid Work Requirements: u003cbru003eData 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.

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • The Pandemic Has Exacerbated Long-Standing Health Care Challenges Faced By Puerto Rico and Other U.S. Territories as the End of Temporary Federal Medicaid Funding Approaches

    News Release

    A new KFF analysis examines how the coronavirus pandemic is affecting U.S. territories as well as issues related to the upcoming expiration of temporary Medicaid funding for the territories at the end of September. Prior to the pandemic, the U.S territories –– American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) -- faced an array of longstanding fiscal and health challenges that were exacerbated by…

  • How Can Trump Administration Regulations Be Reversed?

    Issue Brief

    With the inauguration of President Biden and Democrats holding a slim majority in Congress, policymakers are likely to consider whether and how to reverse various health policy regulations issued by the Trump Administration.

  • Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond

    Report

    Medicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can make health care difficult to afford. This report analyzes several policy options that could help make health care more affordable for people covered by Medicare, especially beneficiaries with relatively low incomes: adding an out-of-pocket limit to traditional Medicare, adding a hard out-of-pocket cap to Part D, expanding financial assistance through…

  • Analysis of National Trends in Medicaid and CHIP Enrollment During the COVID-19 Pandemic

    Issue Brief

    This data note looks at national and state-by-state Medicaid and CHIP enrollment data through December 2022. After declines in enrollment from 2017 through 2019, preliminary data for December 2022 show that total Medicaid/CHIP enrollment grew to 92.3 million, an increase of 21.2 million from enrollment in February 2020 (29.8%), right before the pandemic and when enrollment began to steadily increase (Figure 1).

  • Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic

    Issue Brief

    This data note looks at state Medicaid managed care enrollment data through March 2021 to assess the impact of the COVID-19 pandemic and economic crisis on Medicaid enrollment. Data collected for 29 states show that the rate of Medicaid managed care enrollment growth was 18.8% when comparing managed care enrollment from March 2020 through March 2021. The rate accelerated compared to March 2020 through September 2020 and reversed the trend seen from March 2019 to…

  • A Look at How Medicaid Agencies Are Assisting with the COVID-19 Vaccine Roll-Out

    Issue Brief

    As of February 2021, there are three COVID-19 vaccines approved for emergency use in the U.S. and states are playing a central role in their timely distribution and prioritizing eligible populations. Because Medicaid covers for over 77 million enrollees, including groups disproportionately at risk of contracting COVID-19 as well as hard-to-reach groups, Medicaid agencies can be important partners for the public health agencies that are typically leading the state COVID-19 vaccination efforts. This brief provides…

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • COVID-19 Has Claimed the Lives of 100,000 Long-Term Care Residents and Staff

    Policy Watch

    More than 100,000 residents and staff have died in long-term care facilities since the start of the pandemic. This post discusses the implications of the likely rise in cases due to holiday gatherings and the share of total COVID-19 deaths that have happened in long-term care facilities.

  • Get Ready for a Lot of Biden Executive Orders on Health Care

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt explores what President-elect Biden might do to advance his health care vision both through legislation and through executive orders and waivers and demonstrations.