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Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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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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  • Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and…

  • Puerto Rico: Fast Facts

    Fact Sheet

    Puerto Rico: Fast Facts provides a quick snapshot of the island's demographic, health, and economic characteristics. It also provides some information on federal Medicaid rules, infrastructure, and fiscal challenges ahead.

  • Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes

    Issue Brief

    Medicaid payments to hospitals, which include base and supplemental payments, play an important role in hospital finances and can affect beneficiaries’ access to care.This brief provides an overview of Medicaid payments for hospitals and explores the implications of the ACA Medicaid expansion, including changes in uncompensated care, as well as payment policy changes on hospital finances.

  • Uncompensated Hospital Care Fell by $6 Billion Nationally in 2014, Primarily in Medicaid Expansion States; However Many Hospitals Worry About Future Changes in Medicaid Supplemental Payments

    News Release

    The Affordable Care Act’s coverage expansions have benefited hospitals financially, helping to produce an overall decline nationwide in uncompensated care from $34.9 billion to $28.9 billion in 2014, according to a new analysis by the Kaiser Family Foundation. Nearly all of the decline occurred in Medicaid expansion states, where uncompensated care costs were $10.8 billion in 2014 – down $5.7 billion, or 35 percent, from 2013, the year before ACA coverage expansions took full effect. The…

  • Approved Changes in Indiana’s Section 1115 Medicaid Waiver Extension

    Issue Brief

    On February 1, 2018, the Centers for Medicare and Medicaid Services (CMS) approved an amended extension of Indiana’s Healthy Indiana Program 2.0 (HIP 2.0) Section 1115 demonstration waiver. Indiana’s waiver initially implemented the ACA’s Medicaid expansion from February, 2015 through January, 2018 by modifying Indiana’s pre-ACA limited coverage expansion waiver (HIP 1.0). Unlike other states that implemented the ACA’s Medicaid expansion through a waiver, Indiana’s demonstration also changes the terms of coverage for non-expansion adults…

  • What Initiatives Are States Considering To Control Prescription Drug Costs in Medicaid?

    News Release

    Rising Medicaid spending on prescription drugs has prompted many states to look for new ways to control such costs. Although drug spending increased more slowly in 2016 than in the previous two years, and although such expenditures constitute only six percent of all Medicaid spending (compared to 10% of national health spending), the high cost of specialty drugs continues to be a particular concern among Medicaid policy directors. A new issue brief from the Kaiser…

  • Poll: Public Mixed on Whether Medicaid Work Requirements Are More to Cut Spending or to Lift People Up; Most Do Not Support Lifetime Limits on Benefits

    News Release

    Ahead of the Midterms, Voters across Parties See Costs as their Top Health Care Concern At a time when the Trump Administration is encouraging state efforts to revamp their Medicaid programs through waivers, the latest Kaiser Family Foundation tracking poll finds the public splits on whether the reason behind proposals to impose work requirements on some low-income Medicaid beneficiaries is to lift people out of poverty or to reduce spending. The Centers for Medicare and…

  • Medicaid Managed Care Plans and Access to Care: Results from the Kaiser Family Foundation 2017 Survey of Medicaid Managed Care Plans

    Report

    Managed care organizations (MCOs) cover nearly two-thirds of all Medicaid beneficiaries nationwide, making managed care the nation’s dominant delivery system for Medicaid enrollees. As the entities responsible for providing comprehensive Medicaid benefits to enrollees by contracting with providers, managed care plans play a critical role in shaping access to care for Medicaid enrollees. Many plan actions are dictated by state policy or contracting requirements; however, plans also have some flexibility to design payment and delivery…