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Medicaid Work Requiremnts

Tracking work requirements

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. KFF is tracking key data and policy information related to Medicaid work requirements and how states are approaching implementation.

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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  • Federal Funding Under the Affordable Care Act

    Fact Sheet

    This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to state and local governments (including state and local health departments and school districts) and private entities (including private employers, health centers, universities, and other community-based…

  • Medicare’s Role for Dual Eligible Beneficiaries

    Issue Brief

    About 9 million low-income seniors and younger people with disabilities in the United States are covered by both Medicare and Medicaid. This brief examines the role of Medicare in providing health coverage for these beneficiaries. Medicare is the primary source of health insurance, while Medicaid provides supplemental coverage, helping with premiums and cost-sharing and paying for services not covered by Medicare. This brief examines overall and per capita Medicare spending for these beneficiaries, including variations…

  • States Getting a Jump Start on Health Reform’s Medicaid Expansion

    Issue Brief

    One of the primary goals of the Affordable Care Act (ACA) is to decrease the number of uninsured through a Medicaid expansion to nearly all individuals with incomes up to 133 percent of the federal poverty level (FPL) ($14,856 for an individual or $25,390 for a family of three in 2012) and the creation of new health insurance exchanges. These coverage expansions, which will take effect in 2014, will eventually cover about 32 million uninsured…

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses

    Report

    This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles' utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For instance, although 20 percent of dual eligibles accounted for more than 60 percent of combined Medicaid and Medicare spending, nearly 40 percent of dual eligibles…

  • The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare

    Issue Brief

    This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles' utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account for most of the group's spending, and dual eligibles who are high cost to the Medicare program are generally not the same individuals who are…

  • Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina

    Fact Sheet

    In the past year, there has been a notable trend of states increasingly utilizing data and technology to modernize, streamline, and gain efficiencies in their Medicaid and CHIP programs. The expanded use of data and technology is not only helping states deal with current budget pressures and decreased administrative resources, but also lays important groundwork for the coverage expansions and new coordinated, streamlined, and technology-driven enrollment process that will go into effect in 2014 under…

  • The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments

    Issue Brief

    One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law's Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at or below 133% of the federal poverty level as of January 2014. A ruling on the Medicaid expansion could have far-reaching impacts on the present…

  • 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…

  • KFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision

    Perspective

    As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether the law overall will leave their own families better off (26 percent), worse off (33 percent), or if it won’t make much difference (34 percent).…