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

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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.

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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  • Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003

    Issue Brief

    Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003 This report provides the latest national and state data on Medicaid enrollment and spending for individuals enrolled in both Medicaid and Medicare, also knows as dual eligibles. Nationally, there are 7.5 million dual eligibles and while they comprise 14 percent of the Medicaid population, they account for 40 percent of Medicaid spending. Issue Paper (.pdf)

  • Asset Transfer and Nursing Home Use

    Issue Brief

    Asset Transfer and Nursing Home Use This issue brief examines asset transfer data of elderly nursing home residents and finds that for those who qualify for Medicaid, their average asset transfer are small, sufficient to cover about one month of private nursing home care. Issue Brief (.pdf)

  • Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid Assets Transfer Practices

    Report

    Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid AssetsTransfer Practices In the Deficit Reduction Act of 2005, Congress tightened Medicaid asset transfer rules for individuals qualifying for Medicaid assistance with nursing home bills. Research on asset transfer shows a low incidence of asset transfers and limited cost savings from tightening such rules. But, because of demographic trends that will increase pressure on Medicaid and concerns that the Medicaid program may be financing care for…

  • Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah

    Report

    With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation's 2004 survey of the experiences of Medicaid beneficiaries under Utah's 2002 waiver provide insights into the implications of limited benefits for the low-income population. The results are featured in the March/April edition of…

  • Health Centers Reauthorization: An Overview of Achievements and Challenges

    Report

    This report reviews the role of community health centers in the nation's health care safety net. Today, over 1,000 federally funded and “look-alike” health centers serve 14.3 million people, three-quarters of whom are uninsured or covered by Medicaid. As health centers look toward legislative reauthorization in 2006, they face several policy challenges reviewed in this report, including an increase in the uninsured populations, potential decreases in Medicaid revenue, and a need to increase health centers'…

  • Key Issues and Opportunities: Implementing the New Medicaid Integrity Program

    Report

    The Deficit Reduction Act of 2005 created a new Medicaid Integrity Program to increase the government's capacity to prevent, detect and address fraud and abuse in the Medicaid program. The new initiative represents the most significant single, dedicated investment the federal government has made in ensuring the integrity of the Medicaid program and offers an opportunity to ensure the efficient administration of the program and promote sound stewardship of state and federal resources. The Kaiser…

  • KYHealth Choices Medicaid Reform: Key Program Changes and Questions

    Fact Sheet

    This fact sheet summarizes the key changes Kentucky has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. Kentucky uses new options related to benefits, cost sharing and long-term care. Fact Sheet (.pdf)

  • Voices of the Storm: Health Experiences of Low-Income Katrina Survivors

    Report

    This report provides key findings from interviews with low-income Katrina survivors about their health care experiences after the storm to provide insight into how they fared and to highlight ways to improve the response to this and future disasters. The report also includes several in-depth, individual profiles of survivors’ health care experiences and highlights some specific experiences of individuals with HIV/AIDS. The report is based on in-person interviews conducted with more than 40 survivors and…

  • Perspectives on Medicare Part D and Dual Eligibles: Key Informants’ Views From Three States

    Report

    In 2006, low-income individuals receiving health coverage through both the Medicaid and Medicare programs, “dual eligibles,” experienced a change in their prescription drug benefit when their Medicaid prescription coverage was replaced by the Medicare prescription drug program known as Medicare Part D. This study provides information on the ongoing successes and challenges that dual eligibles faced in the first eight months of Part D and how different state approaches may affect dual eligibles’ ability to…