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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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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.

Dual Eligibles

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  • Medicaid Financing and Fiscal Management:  A Discussion of the Current Federal-State Partnership and Program Integrity

    Other Post

    Medicaid Financing and Fiscal Management: A Discussion of the Current Federal-State Partnership and Program Integrity The Kaiser Commission on Medicaid and the Uninsured will host a discussion for reporters on Tuesday, March 2, 2004 to discuss Medicaid financing and fiscal management and related proposals for change. Reporters in the area are invited to participate from our office; all reporters are invited to participate via conference call. For more information, call 202-654-1313. Medicaid's Federal-State Partnership: Alternatives…

  • Economic Stress and the Safety Net: A Health Center Update

    Issue Brief

    The issue paper provides data on the demographic profile of health center patients and the revenue sources available for financing their care, including recent increases in federal discretionary funding. It examines the impact of the recent economic downturn on health centers in selected communities, exploring the effect of elevated unemployment levels among lower wage workers, declining private health insurance coverage, and widespread cutbacks in Medicaid--the single most important source of health center financing. Issue Paper…

  • Issues for Medicare Beneficiaries in Long-Term Care Facilities: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Vicki Gottlich, J.D., of the Center for Medicare Advocacy, looks at issues related to the new Medicare prescription drug benefit for people with Medicare who live in nursing homes or other long-term-care settings. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Hearing Their Voices: Lessons from the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA)

    Report

        In 2000, Congress passed a landmark law that gave states the option of extending Medicaid coverage to certain low-income women with breast or cervical cancer. In California, approximately 10,000 women have been assisted by this program. This policy brief, "Hearing Their Voices: Lessons from the Breast and Cervical Caner Prevention and Treatment Act (BCCPTA)," reports on the impact of this program on low-income women in California, using focus group analysis. The report was…

  • Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people with disabilities new information to help them get the most from these programs. Full PDF Report (.pdf) Section 1: Introduction HTML PDF Section 2: Medicare HTML PDF Section 3: Medicaid HTML PDF Section 4: Interaction Between Medicare and Medicaid HTML PDF

  • Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation

    Issue Brief

    Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)

  • Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs

    Issue Brief

    Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver. Issue…