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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.

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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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  • Choosing Premium Assistance: What Does State Experience Tell Us?

    Issue Brief

    Premium assistance programs use federal and state Medicaid and State Children’s Health Insurance Program (SCHIP) funds to purchase private coverage. Overall, few states have premium assistance programs, but interest in premium assistance remains high. This brief examines six state premium assistance programs (in Florida, Idaho, Illinois, Oregon, Utah, and Virginia) that allow families to choose to receive a subsidy to apply to the purchase of private coverage rather than to receive direct Medicaid or SCHIP…

  • New Resources & Briefing Examine Medicaid Long-Term Services and Supports

    Event Date:
    Event

    The following resources by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) examine the latest data findings regarding Medicaid’s long-term services and supports for seniors and people with disabilities. The materials were released at a public briefing in the Foundation’s Washington, D.C. offices that featured an expert panel and remarks on long-term services and supports by U.S. Secretary of Health and Human Services Kathleen Sebelius. The reports include: Medicaid Home and Community-Based…

  • Massachusetts Health Care Reform: Six Years Later

    Issue Brief

    In 2006, then-Gov. Mitt Romney signed Massachusetts' comprehensive health reform designed to provide near-universal health insurance coverage for state residents. Building on a long history of health reform efforts, the state embarked on an ambitious plan to promote shared individual, employer, and government responsibility. This brief examines Massachusetts' experience with coverage and access to care over the last six years, as well as the state's ongoing efforts to deal with persistent high health-care costs. The…

  • Key Facts – Louisiana and the U.S.

    Fact Sheet

    Key Facts - Louisiana and the U.S. A fact sheet on the demographics and health coverage of Louisiana's population Fact Sheet (.pdf)

  • Medicaid Enrollment & Spending Growth: FY 2017 & 2018

    Issue Brief

    This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2017 and 2018. Findings are based on interviews and data provided by state Medicaid directors as part of the 17th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) survey and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.

  • Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2017 and FY 2018

    Issue Brief

    This report provides an in-depth examination of Medicaid program changes in the larger context of state budgets in three states: Nevada, North Carolina and West Virginia. These case studies build on findings from the 17th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA).

  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

  • Medicaid Managed Care and the Provision of Family Planning Services

    Report

    Three quarters of reproductive age women on Medicaid are enrolled in managed care arrangements. This analysis explores the experiences and perspectives of leaders of Medicaid Managed Care Organizations (MCOs) in structuring their networks and services to provide family planning and reproductive health services to women. It finds that MCOs rely heavily on safety net clinics including Community Health Centers and Family Planning Clinics such as Planned Parenthood to provide in-network family planning services to their…

  • Medicaid’s Role for Seniors

    Other Post

    This infographic highlights Medicaid’s role for seniors. It includes information about the senior population and highlights Medicaid’s role in increasing access to and financing treatment, particularly for long-term care. It also discusses the potential impact of proposals to limit federal Medicaid financing.