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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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  • Variations in State Medicaid Buy-in Practices for Low-Income Medicare Beneficiaries: A 1999 Update

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    This report updates a 1997 Foundation report to assess how states are implementing financial protections for the 16 million Medicare beneficiaries who are low-income. These protections, generally referred to as "buy-in programs," help low-income Medicare beneficiaries meet Medicare's cost-sharing requirements by using state Medicaid programs to pay either all or some portion of premiums, deductibles, and coinsurance amounts. Using information collected through a survey of state Medicaid directors and consumer advocates, the update seeks to…

  • Medicaid and Children: Overcoming Barriers to Enrollment

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    Findings from a National Survey This national telephone survey of low-income parents represents a major effort to better understand the barriers to Medicaid enrollment and to test the usefulness of ideas to facilitate enrollment in a quantitative way. Examining both parents of uninsured children who appear eligible for Medicaid and parents with children currently enrolled in Medicaid, the survey findings present: a profile of low-income, Medicaid-eligible children; parents' Medicaid knowledge and perceptions; key barriers to…

  • National Survey on Poverty in America

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    Americans aren't thinking a lot about the poor these days. A new survey by NPR, the Kaiser Family Foundation, and Harvard University's Kennedy School of Government found that only about one in 10 Americans names poverty, welfare, or something similar as one of the two top issues government should address. Nevertheless, when they are asked about it directly, most Americans think that poverty is still a problem in this country, even in these generally prosperous…

  • Statewide Surveys of Californians on Public Attitudes Toward the Single Payer Ballot Initiatives (Proposition 186)

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  • Section 1115 Waivers at a Glance:  Summary of Recent Medicaid and SCHIP Waiver Activity

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  • Enabling Services: A Profile of Medicaid Managed Care Organizations

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    The report provides basic statistics on Medicaid managed care organizations providing enabling services - transportation, translation, education, and case management. The report also identifies the extent of variation across plans. REPORT Download