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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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  • 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…

  • 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…

  • 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…

  • 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).…

  • Small Area Variations and the ACA’s Coverage Expansions

    From Drew Altman

    A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented.  It looks at how the benefits of the ACA's coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs).  PUMAs are artificial areas of about 100,000 people each created by the Census Bureau to provide more detailed demographic, social and economic information at the local level.  They…

  • Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

    Issue Brief

    As part of broad deficit-reduction plans, policymakers are considering reforms to the nation's three major entitlement programs - Medicare, Medicaid and Social Security - that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors' financial security as well as the challenges facing current and future generations when it comes to economic and health security. Drawing from current research and data, the…

  • Governors’ Budgets for FY 2013 — What is Proposed for Medicaid?

    Issue Brief

    This report provides Medicaid highlights from governors' proposed state budgets for FY 2013, which starts July 1, 2012 for most states. While some states are beginning to see signs of economic recovery, many remain cautiously optimistic as they continue to experience the recession's lingering effects. State revenues have not rebounded to pre-recession levels, unemployment rates are still high, and some states continue to face budget shortfalls. There continues to be high demand for Medicaid and…