Medicaid

Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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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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  • States Strive to Limit Medicaid Expenditures for Prescribed Drugs

    Report

    A new report presenting year 2000 trends on prescription drug spending, summarizing states options in designing their benefit, and reviewing several ways states are using their flexibility to curb the rate of growth of their Medicaid drug budgets. Background Paper

  • States’ Concerns About the Medicare Drug Debate and the Fiscal Impact of Shifting the Cost of Dual Eligible Care

    Issue Brief

    As the U.S. Congress continues to search for an agreement on the form of a Medicare prescription drug benefit, the Commission has two new reports related to the debate. One new publication reports on findings from an October 26 discussion with state Medicaid officials on the implications of a Medicare drug benefit for states and dual eligibles. The other report provides state-level estimates on spending on dual eligibles and illustrates the effects of scenarios where…

  • Medicaid Mental Health and Substance Use: Expansion Trends and the Fiscal Pressure Ahead

    Issue Brief

    This brief examines recent state trends in Medicaid behavioral health coverage and payment and state coverage of select treatment models for people with serious mental illness—a population that has historically faced significant barriers to care. This includes details about coverage of Certified Community Behavioral Health Clinics (CCBHCs) (as a provider type), Assertive Community Treatment (ACT), and Coordinated Specialty Care for First Episode Psychosis (CSC-FEP).

  • Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries

    Issue Brief

    On May 22, the House passed a reconciliation bill, the One Big Beautiful Bill Act, which would partially pay to extend expiring tax cuts by cutting Medicaid. The Congressional Budget Office (CBO) estimates that the bill would reduce federal Medicaid spending by $793 billion over ten years and 10.3 million fewer people would be enrolled in Medicaid in 2034, including 1.3 million people with Medicare, otherwise known as “dual-eligible individuals”.

  • Medicaid Expansion is a Red and Blue State Issue

    Issue Brief

    With President-elect Trump returning to the White House and Republicans controlling Congress, significant changes to the Medicaid expansion are expected. This data note provides key facts on the Medicaid expansion, highlighting the financial and coverage impacts of any changes across states that voted for President-elect Trump and those that voted for Vice President Harris.

  • There Were 14,742 Certified Nursing Facilities in the U.S. in 2025

    A Look at Nursing Facility Characteristics in 2025

    Issue Brief

    This data note discusses the impact of the 2025 reconciliation law on nursing facilities and examines the characteristics of nursing facilities and the people living in them with data from Nursing Home Compare, a publicly available dataset.

  • Implications of Congress Eliminating Major Biden Era Regulations for Medicaid

    Policy Watch

    The Biden administration finalized several major Medicaid regulations with the intent of improving access to Medicaid services. Collectively, the rules span hundreds of pages of text, are extremely complex, and were set to be implemented over several years, with measurable increases in federal Medicaid spending. Overturning the rules would reduce regulation of managed care companies, nursing facilities, and other providers; increase barriers to enrolling in and renewing Medicaid coverage, and roll back enrollee protections, payment…