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5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

Tracking Medicaid Work Requirements:
Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage

  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.

  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.

  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Where Is The Growth in the Uninsured Population Coming From?

    Other Post

    The Kaiser Commission on Medicaid and the Uninsured co-sponsored a policy briefing today to discuss the dynamics of the uninsured population in America. In 2001, the uninsured population grew by 1.4 million people.

  • Medicaid Enrollment in the 50 States: A June 2002 Data Update

    Report

    This publication provides state-by-state enrollment information and identifies national trends from the data. The report focuses on the five-year period from June 1997 to June 2002. In June 2002,total Medicaid enrollment in the United States reached over 38.1 million persons. This was an increase of nearly 3.

  • Welfare Reform and Elderly Legal Immigrants

    Report

    This report presents the findings of researchers at the National Academy on Aging on welfare reform and elderly legal imigrants. The Personal Responsibility and Work Opportunity Reconciliation Actof 1996 included an array of structural reforms affecting access to cash assistance programs such as AFDC and SSI as well as Medicaid.

  • The Role of Health Coverage for People with Disabilities

    Event Date:
    Event

    People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care.

  • Children’s Medicaid and SCHIP in Texas:  Tracking the Impact of Budget Cuts

    Report

    Children’s Medicaid and SCHIP in Texas: Tracking the Impact of Budget Cuts The case study details the impact of Texas' legislative actions on enrollment in its Medicaid and SCHIP programs. Texas experienced the largest SCHIP enrollment decline in the nation between June 2003 and December 2003. Executive Summary (.pdf) Full Report (.

  • Checking Up on Children’s Health Coverage:  A Progress Report on Medicaid and SCHIP

    Report

    Checking Up on Children's Health Coverage: A Progress Report on Medicaid and SCHIP At a July 23, 2004 Washington, DC policy briefing two new Kaiser Commission on Medicaid and the Uninsured reports show State Children's Health Insurance Program enrollment declined in the second half of 2003 and examine what led to Texas' enrollment decline.

  • Medicaid Spending and Enrollment: State and National Data Update

    Report

    This series of tables provides recent data on state-by-state and national Medicaid spending and enrollment. Using the latest federal information sources available, the first set of tables contains information on Medicaid spending by service using data from the Centers on Medicaid and Medicare Services (CMS) Form 64 for Federal Fiscal Year (FFY) 2004.

  • Nursing Home Transition Programs: Perspectives of State Medicaid Officials

    Report

    Nursing Home Transition Programs: Perspectives of State Medicaid Officials This report draws on interviews with state Medicaid program officials for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings.