Medicaid

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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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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  • National Survey of the Public’s Views About Medicaid – Chartpack

    Report

    This chartpack provides key findings from the national survey of the public on their views about Medicaid. The survey was conducted in April and May of 2005. The survey includes findings on Americans' personal experience with Medicaid, their knowledge of the program, and their opinion about the program's coverage and funding by the state and federal government. Chartpack (.pdf)

  • Women and Health Care: A National Profile – Report

    Report

    Report - Women and Health Care: A National Profile Women and Health Care: A National Profile is a nationally representative telephone survey of 2,766 women ages 18 and older. A shorter companion survey of 507 men was also conducted. Full Report (.pdf) Report Highlights (.pdf) Introduction and Methods (.pdf) Chapter 1: The Demographics of Women (.pdf) Chapter 2: The Health of Women (.pdf) Chapter 3: Women and Health Insurance Coverage (.pdf) Chapter 4: Women's Access…

  • Private Long-Term Care Insurance: A Viable Option for Low and Middle-Income Seniors?

    Issue Brief

    In the Deficit Reduction Act of 2005, the federal government made it harder for individuals to qualify for Medicaid nursing home benefits by increasing penalties on individuals who have transferred assets for less than fair market value during the past five years and by making individuals with home equity above $500,000 ineligible for nursing home benefits. The legislation also lifts the moratorium on the number of states that may operate Long-Term Care (LTC) Partnership Programs,…

  • Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    This updated fact sheet describes the nearly 8.9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and what the new health reform law may mean for them. Fact Sheet (.pdf)

  • Trends in Medicaid Physician Fees, 2003-2008

    Fact Sheet

    This study, published in a Health Affairs Web exclusive, provides the first national and state-by-state update of Medicaid physician fees since 2003. Medicaid has historically reimbursed physicians under fee-for-service at levels below what Medicare and private health insurers would pay for the same services. The study finds that Medicaid fees grew by more than 15 percent from 2003 to 2008, but fell in real terms because the gains did not keep pace with inflation. Medicaid…

  • Putting Children on the Express Lane to Health Insurance: Streamlining Enrollment and Renewal of Children in Medicaid and CHIP Through Express Lane Eligibility

    Issue Brief

    Express Lane Eligibility (ELE) is a new tool available to states to streamline enrollment and renewal of children in Medicaid and CHIP. It allows state Medicaid and CHIP agencies to utilize data and eligibility findings from other public need-based programs, such as Head Start or Food Stamps, and/or tax return data to identify, enroll and recertify children rather than requiring them to re-analyze and determine eligibility under their own rules. A primary goal of this…

  • State Medicaid Coverage of Perinatal Services: Summary of State Survey Findings

    Issue Brief

    The report examines state Medicaid program policies regarding coverage of pregnancy-related services. It details state-level Medicaid eligibility and enrollment policies for pregnant women, as well as scope of coverage for prenatal and screening services, delivery and post-partum care, educational classes and support services.

  • Medicaid’s Continuing Crunch In a Recession: A Mid-Year Update for State FY 2010 and Preview for FY 2011

    Report

    This report finds that 44 states and the District of Columbia are experiencing higher than expected program enrollment and spending for fiscal year 2010. At least 29 states say they are considering additional mid-year cuts in provider rates and program benefits. The recession and the scheduled end on Dec. 31, 2010 of enhanced federal matching money for Medicaid that was provided through the American Recovery and Reinvestment Act of 2009 will have a significant impact…

  • Mental Health Financing in the United States: A Primer

    Report

    This primer provides an overview of behavioral health care, reviews the sources of financing for such care, assesses the interaction between different payers, and highlights recent policy debates in mental health. It also discusses the role of Medicaid, currently the largest source of financing for behavioral health services in the nation, covering a quarter of all expenditures. This comprehensive resource serves as a guide for those who want to understand the complex system of behavioral…

  • Explaining Douglas v. Independent Living Center: Questions About the Upcoming United States Supreme Court Case Regarding Medicaid Beneficiaries’ and Providers’ Ability to Enforce the Medicaid Act

    Issue Brief

    On October 3, 2011, the U.S. Supreme Court is scheduled to hear oral argument in a group of three cases, Douglas v. Independent Living Center of Southern California, Douglas v. California Pharmacists Association, and Douglas v. Santa Rosa Memorial Hospital. All three cases raise the same issue: whether Medicaid beneficiaries and providers can challenge a state law in federal court on the basis that it violates the federal Medicaid Act and therefore is “preempted” by…