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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.

Dual Eligibles

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  • Medicaid 1915(c) Home and Community-Based Service Programs: Annual Data Update

    Issue Brief

    Developing home and community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last two decades and the focus of Medicaid policy debates recently. While the majority of Medicaid long-term care dollars go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 1992 to 2003. This report presents a summary of the main trends to emerge from the data for…

  • State Children’s Health Insurance Program at a Glance

    Fact Sheet

    A fact sheet that provides an overview of how the State Children's Health Insurance Program is administered and financed, who is eligible, what services are covered, and what the policy issues are for the program's reauthorization. Fact Sheet (.pdf)

  • A Decade of SCHIP: Experience and Issues for Reauthorization

    Issue Brief

    A Decade of SCHIP: Experience and Issues for Reauthorization As the SCHIP program is due for reauthorization in 2007, this brief explores some lessons learned and highlights key policy issues for the upcoming debate. Issue Brief (.pdf)

  • The State Children’s Health Insurance Program: Lessons and Outlook

    Event

    The State Children's Health Insurance Program: Lessons and Outlook Barbara Lyons, a vice president of the Foundation and deputy director of the Foundation's Commission on Medicaid and the Uninsured, testified before a field hearing of the U.S. Committee on Finance about lessons learned from ten years of the State Children's Health Insurance Program and the outlook for the program's future. Testimony (.pdf)

  • Medicaid’s Role for People With Disabilities

    Event

    Diane Rowland testified before the House Energy and Commerce Subcommittee on Health about Medicaid’s development as a vital source of coverage for people with disabilities and its current role providing coverage and access to health services and supports for this population. Testimony (.pdf)

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Medicaid’s Role for Dual-Eligible Beneficiaries

    Issue Brief

    This brief examines the role of Medicaid in providing health coverage to the 9.6 million Medicare beneficiaries who are also eligible for Medicaid. The brief explains the role Medicaid plays in providing supplemental coverage to fill in the gaps in Medicare’s coverage for these dual-eligible beneficiaries.

  • Building an Information Technology Foundation for Health Reform: A look at Recent Guidance and Funding Opportunities

    Issue Brief

    The major coverage provisions in the Affordable Care Act (ACA) go into effect in January 2014 with an expansion of Medicaid eligibility to nearly all individuals under 138% of poverty and new subsidies for individuals with incomes between 138% and 400% of poverty to purchase coverage in newly established Health Insurance Exchanges. The ACA envisions a streamlined and simplified application process with seamless transitions between coverage in the Exchange and Medicaid. Using a web portal,…

  • Managing Costs and Improving Care: Team-based Care of the Chronically Ill

    Event Date:
    Event

    Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs. This briefing, cosponsored by the Alliance for Health Reform and The Commonwealth Fund, looked at ways to improve the quality of care for the chronically ill while reducing the growth in spending for their care.…

  • Integrating Care for Dual Eligibles: What Do Consumers Want?

    Event Date:
    Event

    Many deficit reduction plans have recognized the need to improve care for the 9 million beneficiaries dually eligible for Medicare and Medicaid. How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are Health and Human Services initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kind of programs are currently available? What do consumers think about different ways of getting care? What lessons for program design can…