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 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.

Dual Eligibles

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  • Health Coverage for Low-Income Americans:  An Evidence-Based Approach to Public Policy

    Report

    Health Coverage for Low-Income Americans: An Evidence-Based Approach to Public Policy This report offers an evidence-based framework for developing public policy approaches to covering low-income Americans. The first part of the report is devoted to the question: What is the role for publicly sponsored health insurance? The second part turns to seven central issues in structuring a publicly sponsored health insurance program for the low-income population. The report outlines each of these issues, provides a…

  • Family Coverage Under SCHIP Waivers

    Issue Brief

    Currently, eleven states cover parents with SCHIP funds via a federal waiver. This paper examines these programs and considers them within the context of the states' efforts to cover children. Issue Brief (.pdf)

  • Health Coverage for Children and Families in Medicaid and SCHIP:  State Efforts Face New Hurdles

    Report

    Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles The seventh annual 50-state survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and SCHIP for children and families reports that nearly two-thirds of states expanded access to Medicaid and SCHIP between July 2006 and January 2008. Executive Summary (.pdf) Report (.pdf)

  • Report Examines the Potential Impact of New Federal Initiative To Review Payment and Eligibility Errors in Medicaid

    Report

    Report Examines the Potential Impact of New Federal Initiative To Review Payment and Eligibility Errors in Medicaid The federal government has launched a new initiative, Payment Error Rate Measurement (PERM), to estimate the number of errors states make in determining eligibility for Medicaid and the State Children’s Health Insurance Program (SCHIP). This paper reports on interviews of state officials conducted during the summer of 2007. The primary findings include: State officials generally find measuring errors…

  • President’s FY 2009 Budget and Medicaid

    Fact Sheet

    President's FY 2009 Budget and Medicaid The President released his Fiscal Year 2009 budget plan in January 2008. The President would reduce federal Medicaid spending by over $17 billion over the next five years by reducing the federal match rate for certain services, making changes to managed care, long-term care, reimbursement for prescription drugs and making other administrative changes. This fact sheet summarizes the proposals and potential implications. Fact Sheet (.pdf)

  • Pulling It Together: Perspectives on State Health Reform

    Perspective

    This Pulling It Together column is the fourth in my new series. All four so far have dealt with different dimensions of health reform. This time I write about one of my favorite topics, the states. As a former head of an umbrella health and social services agency in a big state responsible for about a third of a state budget and workforce, I have a deep appreciation for state government. It's a level of…

  • Care and Coverage of the Nation’s Children: A Resource Page

    Fact Sheet

    Medicaid and the Children's Health Insurance Program (CHIP) are serving as an important safety-net for children during the current recession. These programs have contributed to a decrease in the uninsured rate for children, but many eligible children remain uninsured despite the availability of Medicaid and CHIP coverage today. Provisions to strengthen coverage for children are included in both the 2009 Children’s Health Insurance Program Reauthorization Act and the Patient Protection and Affordable Care Act of…

  • American Recovery and Reinvestment Act (ARRA): Medicaid and Health Care Provisions

    Fact Sheet

    This fact sheet examines the assistance for Medicaid programs and key health provisions in the American Recovery and Reinvestment Act (ARRA) that President Obama signed into law on February 17, 2009. Subjects covered include the temporary increase in federal matching money for state Medicaid programs, subsidies for COBRA health coverage for laid off workers and funding for health information technology. It includes a breakdown of additional federal allocations to states for Medicaid costs under the…

  • The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare

    Issue Brief

    This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles' utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account for most of the group's spending, and dual eligibles who are high cost to the Medicare program are generally not the same individuals who are…