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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • Premium Assistance Programs:  How Are They Financed and Do States Save Money?

    Issue Brief

    Premium Assistance Programs: How Are They Financed and Do States Save Money? This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness; and cost savings. Issue Brief (.pdf) Executive Summary (.pdf)

  • An Implementation Perspective on Part D, the Medicare Prescription Drug Program

    Report

    This focus group of 12 state Medicaid officials conducted in November 2005 explores the current status and likely results of the Part D dual eligible transition efforts as well as other Part D-related issues of particular importance to states. It includes discussion of the transition of dual eligibles from Medicaid to Medicare drug coverage, evaluating Part D plan options, states’ role in the low-income subsidy program, the fiscal implications of Part D to states, and…

  • Choices Under the New State Child Health Insurance Program: What Factors Shape Cost and Coverage? – Policy Brief

    Issue Brief

    Choices Under The New State Child Health Insurance Program: What Factors Shape Cost And Coverage? January 1998 The State Children's Health Insurance Program (CHIP), enacted as part of the Balanced Budget Act of 1997, provides over $20 billion in federal funds over five years to cover low-income uninsured children. This program gives states considerable flexibility in designing expanded health insurance coverage for children. The way states design their programs -- use of Medicaid or a…

  • Pulling it Together: Teaching An Old Dog New Tricks

    Perspective

    Way back in the eighties when I was Human Services Commissioner in New Jersey, I established something called the Garden State Health Plan (GSHP).  It was the first — and I think the only — federally qualified state-run HMO for Medicaid beneficiaries.  One goal of the GSHP was to reallocate the Medicaid dollar, giving more to primary care physicians who at the time were paid $9 for a general office visit, and a little less…

  • Hispanics and the New Medicare Drug Benefit

    Poll Finding

    In a few short weeks, Medicare will undergo big changes that will have a major impact on more than 3 million Hispanic seniors and younger people with permanent disabilities who rely on Medicare for their health coverage. More than one in three Hispanics with Medicare lack coverage for their prescription drugs for at least part of the year. Many others will need to make decisions about their existing coverage and the new Medicare benefit. Starting…

  • Enrolling Uninsured Low-Income Children in Medicaid & SCHIP

    Fact Sheet

    This fact sheet outlines issues in outreach and enrollment for Medicaid and SCHIP. It provides a profile of eligible but uninsured children, discusses the greatest barriers to enrollment, and offers strategies to improve enrollment. Fact Sheet (.pdf)

  • Aging Out of Early and Periodic Screening, Diagnostic and Treatment (EPSDT): Issues for Young Adults with Disabilities

    Issue Brief

    Early and Periodic Screening, Diagnostic and Treatment (EPSDT) coverage offered through the Medicaid program has played an important and unique role for low-income children with disabilities, and maintaining this support is a key concern. This issue brief discusses the challenges and implications for young people with disabilities when they become adults and lose their EPSDT benefits and how recent changes to the Deficit Reduction Act give states an opportunity to increase the availability of services…

  • New Survey Indicates Medicaid Enrollment Declines For First Time In Nearly A Decade

    Event Date:
    Event

    The annual 50-state survey of state officials on Medicaid and state budget actions reports enrollment in Medicaid declined for the first time in nearly a decade. The 0.5 percent enrollment decline in fiscal year 2007 was driven primarily by two factors. States reported that the new citizenship documentation requirements were causing significant delays in processing applications, affecting mostly individuals already eligible for the program. State officials also cited the good economy and lower unemployment for…

  • State Medicaid Coverage of Family Planning Services: Summary of State Survey Findings

    Other Post

    State Medicaid Coverage of Family Planning Services: Summary of State Survey Findings Over the past two decades, Medicaid has played a central and growing role in financing and providing access to family planning services for low-income women. About two-thirds of women covered by Medicaid are of child-bearing age, and for this group of women, access to family planning services fills a key health need. This report highlights findings from the 2007/2008 State Survey of Reproductive…

  • Resources Examine Medicaid Enrollment Growth And State Budget Pressures

    Fact Sheet

    This package of resources examines the substantial enrollment growth in Medicaid between June 2008 and June 2009 and provides a mid fiscal-year 2010 update on key state Medicaid issues, including the impacts of the economic downturn. News ReleaseWith the country in a deep recession, nearly 3.3 million more people were enrolled in state Medicaid programs in June 2009 compared to the previous June, according to a new analysis, Medicaid Enrollment: June 2009 Data Snapshot (updated for…