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Medicaid work requirements

Tracking the 2025 Reconciliation Law’s 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.

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

    Fact Sheet

    Dual Enrollees: Medicaid's Role for Low-Income Medicare Beneficiaries This fact sheet describes the low-income elderly population that is eligible for both Medicaid and Medicare, why they need Medicaid, what services they receive from Medicaid, and the current policy challenges related to this population. Fact Sheet (.pdf)

  • Low-Income Medicare Beneficiaries: How the House and Senate Prescription Drug Bills Address Their Drug Needs

    Report

    The House and Senate versions of a Medicare prescription drug bill treat the drug costs of those dually-eligible for Medicare and Medicaid and other low-income Medicare beneficiaries quite differently. The Kaiser Commission on Medicaid and the Uninsured cosponsored a policy briefing on the key issues in the two bills that would impact low-income beneficiaries and released a brief and background report on the topic. A Prescription Drug Benefit in Medicare: Implications for Medicaid and Low-Income…

  • The Future of New Orleans: Young Adults in the Greater New Orleans Area

    Poll Finding

    Using data from the Kaiser Post-Katrina Baseline Survey of the New Orleans Area, this Survey Brief profiles young adults (those ages 18-34) living in the Greater New Orleans area, a group that will play a key role in the success and rebuilding of New Orleans. The brief looks at whether they plan to stay in the New Orleans area, their outlook for the future, their demographic profile, and some of the challenges they face. The…

  • Closing the Long-Term Care Funding Gap: The Challenge of Private Long-Term Care Insurance

    Issue Brief

    This policy brief from the Kaiser Commission on Medicaid and the Uninsured examines the fundamentals of private long-term care insurance. It describes the results of a study exploring how consumers buy policies, how much policies cost and how they work, and what regulations exist to protect consumers. It also discusses some key challenges that policymakers face when considering whether to enlarge the role of private long-term care insurance in financing long-term care. Policy Brief (.pdf)

  • A Guide to the Medicaid Appeals Process

    Issue Brief

    This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services, but the process is multi-layered and can be complex to navigate. The guide describes Medicaid's appeals system, including the fair hearing process and the appeals…

  • The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers

    Fact Sheet

    For many years, Section 1115 waivers have been used in the Medicaid program to provide states an avenue to test and implement coverage approaches that do not meet federal program rules, but there have been longstanding concerns about the lack of public input and transparency in the waiver approval process. As a result, the Affordable Care Act required the Department of Health and Human Services to issue regulations designed to ensure that the public has…

  • Opening Doorways to Health Care for Children: 10 Steps to Ensure Eligible but Uninsured Children Get Health Insurance

    Report

    Despite the success of Medicaid and SCHIP in reducing the number of uninsured low-income children by one-third in the last decade, over eight million children remain uninsured. Seventy percent of these uninsured children are eligible for public health coverage. This report by the Children's Partnership lays out a plan for creating a series of enrollment doorways that make enrollment and renewal of children both routine and timely -- as close to automatic as possible. The…

  • Migrant and Seasonal Farmworkers:  Health Insurance Coverage and Access to Care

    Report

    Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care Nearly three million workers earn their living through migrant or seasonal farm labor. Migrant and seasonal farmworkers and their families confront health challenges stemming from the nature of their work, their extreme poverty and mobility, and living and working arrangements that impede access to health coverage and care. This brief provides an overview of migrant and seasonal farmworkers and the health challenges they face…