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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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  • Only Six Percent of Adult Medicaid Enrollees Targeted by States’ New Work Requirements Are Not Already Working and Are Unlikely to Qualify for an Exemption

    News Release

    Among enrollees targeted in the push for work requirements for “able-bodied adults” in Medicaid, only 6 percent are not already working and unlikely to qualify for an exemption, according to an analysis from the Kaiser Family Foundation. Nationally, more than 6 in 10 nonelderly adults in Medicaid who do not receive federal disability or Medicare coverage are already working full-time (43%) or part-time (19%), the analysis finds. Nearly a third of nonelderly adults in Medicaid…

  • New Analysis Illustrates Potential Impact of Medicaid Work Requirements on Coverage if Implemented Nationally as Called for by House Budget Committee and Senate Legislation

    News Release

    As a number of states pursue Medicaid waivers to require certain beneficiaries to work in order to receive benefits, the House Budget Committee passed a budget resolution this month calling for the enactment of Medicaid work requirements in all states, a goal also advanced in proposed legislation in the Senate by Sen. John Kennedy of Louisiana. Although details are scant at this point, a new analysis from the Kaiser Family Foundation provides illustrative scenarios of…

  • Un año después de las tormentas: la recuperación y la atención de salud en Puerto Rico y las Islas Vírgenes de EE.UU. (Informe)

    Issue Brief

    Un año después que los huracanes Irma y María tocaran tierra, Puerto Rico y las Islas Vírgenes de EE.UU. (USVI) todavía sienten los efectos de las tormentas. Basándose en entrevistas con partes interesadas clave y en informes públicos, este reporte proporciona una visión general del estado de recuperación y los esfuerzos de preparación para la actual temporada de huracanes, un año después de las tormentas, enfocándose en los sistemas de atención de salud de los…

  • What do different data sources tell us about Medicaid and work?

    Fact Sheet

    A central question in the ongoing debate about imposing work requirements in Medicaid is what current work patterns are among Medicaid adults and how many so-called “able bodied” adults are not already working. Answers to these questions rely on various data sources, and characteristics of the underlying data and analytic decisions may lead to different conclusions. This data note examines what different data sources and analytic decisions tell us about Medicaid and work.

  • SCHIP Program Enrollment:  December 2003 Update

    Report

    SCHIP Program Enrollment: December 2003 Update The latest survey of states on State Children's Health Insurance Program shows an enrollment decline in the second half of 2003--the first decline in the six-year history of the program. Report (.pdf)

  • Enrollment Increases in State CHIP Programs: December 1998 to June 1999

    Report

    A new survey of state officials, conducted by Vernon Smith of Health Management Associates for the Kaiser Commission on Medicaid and the Uninsured, found that the number of children enrolled in stateCHIP programs has grown to more than 1.3 million in June 1999 from about 835,000 in December 1998. The survey was released at the July 30th Alliance for Health Reform Briefing on state efforts to enroll more kids in the Children's Health Insurance Program.…

  • Financing Health Coverage:  The State Children’s Health Insurance Program Experience

    Issue Brief

      Financing Health Coverage: The State Children's Health Insurance Program Experience Enactment of SCHIP sought a balance between increasing funds available for coverage and limiting total federal outlays. While SCHIP has had widespread support and success in helping to provide coverage for uninsured children, its capped financing system has also created challenges for states, including inequities among states and projected federal funding shortfalls. This issue brief explores three basic sets of issues associated with SCHIP’s…

  • Medicaid and Budget Reconciliation: Implications of the House and Senate Bills

    Issue Brief

    This issue brief provides an overview of the federal budget context and then highlights key Medicaid savings proposals in the House and Senate bills and discusses the implications of the proposed changes. Issue Brief (.pdf) Updated Issue Brief - Medicaid and Budget Reconciliation: Implications of the Conference Report (January 2006)

  • Cover the Uninsured Week 2006 – Kaiser Family Foundation Resources

    Fact Sheet

    May 1-7, 2006, is Cover the Uninsured Week, organized by The Robert Wood Johnson Foundation and several partner organizations. The Kaiser Family Foundation has a wide range of resources on the topics of health coverage and the nation's uninsured population to assist you in your work related to these issues. The Robert Wood Johnson Foundation launches the Week at a May 2 event in Washington, D.C. Webcast Fact Sheets & Primer The Uninsured and Their…