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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  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • Medicaid’s Role in Long-Term Care: Q & A

    Fact Sheet

    Financing long-term care for the nearly 10 million Americans who need services and support to assist them in life’s daily activities continues to challenge the nation. While Medicaid is the nation’s major source of financing for long-term care services, paying for over 40% of total long-term care, its role is not well understood. Misperceptions on who qualifies and what is covered are common. A new question and answer fact sheet about Medicaid’s long-term care assistance…

  • Two New Reports Show Progress On Health Coverage Is Threatened As States Continue To Face Growing Pressures To Control Costs

    Report

    Two New Reports Show Progress on Health Coverage is Threatened as States Continue to Face Growing Pressures to Control Costs Two new KCMU 50-state surveys show states continue to face budget pressures that could limit public coverage. One survey shows all states plan more Medicaid cost-containment actions in FY2005 and the second shows that after recent gains, securing Medicaid and SCHIP coverage is more difficult for low-income families in 23 states. News Release The Continuing…

  • Spotlight on Uninsured Parents: How a Lack of Coverage Affects Parents and Their Families

    Issue Brief

    Providing health coverage for the entire family can both help to increase coverage of children and assist low-income families in obtaining more affordable health care services. This brief uses data from the 2005 Kaiser Low-Income Coverage and Access Survey to examine health coverage, access and the financial impacts of health care for low-income parents and their families. Issue Brief (.pdf)

  • Coverage Gains Under Recent Section 1115 Waivers: A Data Update

    Issue Brief

    This brief assesses the extent to which recent Section 1115 waivers have helped reduce the number of uninsured people and finds that there has been a net gain in coverage of 426,329 people under recent waivers. Issue Paper (.pdf)

  • Building an On-Ramp to Children’s Health Coverage:  A Report on California’s Express Lane Eligibility Program

    Report

    Building an On-Ramp to Children's Health Coverage: A Report on California's Express Lane Eligibility Program This report documents the results from California’s Express Lane Eligibility (ELE) initiative through the school lunch program (now one year into implementation), which has been piloted in 72 schools in 5 school districts in the state. ELE is an enrollment strategy that targets large numbers of uninsured children, who are eligible for the federal-state programs Medicaid and SCHIP, where they…

  • Resources Related to Health Coverage and Hurricane Katrina

    Fact Sheet

    Health Care and Hurricane Katrina As part of the Kaiser Family Foundation's commitment to help respond to the devastation from Hurricane Katrina, you will find resources related to an ongoing effort to monitor and study the health coverage and needs of the victims. Check back frequently in the coming months for the latest updates. Recent Resources Testimony—Health Care In New Orleans: Progress and Remaining Challenges New Orleans Three Years After the Storm: The Second Kaiser…

  • National Survey of Physicians Part IV: Doctors, Payors, and Low-Income Patients

    Poll Finding

    As part of the Kaiser Family Foundation's National Survey of Physicians, this portion of the survey examines differences in provider payment rates from different payors, such as Medicaid, Medicare, and private insurers, and explores providers experiences with these different payors and with providing treatment for uninsured and low-income patients. Highlights and Chart Pack

  • New Reports Explore State Implementation of Prescription Drug Prior Authorization

    Other Post

    States are grappling with a fiscal crisis that threatens funding for Medicaid, the federal-state partnership that provides health coverage for low-income populations. Two new studies shed light on the impact of an increasingly popular strategy - prior authorization - being used to control prescription drug spending. In fiscal year 2003, some 21 states are planning to expand or create prior authorization systems where the state must provide pre-approval before selected drugs can be dispensed to…

  • Why Did Medicaid Spending Decline in 2006?  A Detailed Look at Program Spending and Enrollment, 2000-2006

    Issue Brief

    Why Did Medicaid Spending Decline in 2006? A Detailed Look at Program Spending and Enrollment, 2000-2006 This issue brief finds that Medicaid spending declined for the first time in the program’s 40-plus year history in Federal Fiscal Year (FY) 2006, falling by 0.2 percent. The two major factors that underlie the 2006 decline, in addition to a more limited effect of the slowdown in per enrollee spending growth for a few key services, were the…