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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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  • Children Head Back to School Amid an Ongoing Pandemic That Has Had Significant Effects on Their Health and Well-Being

    News Release

    As students head back to in-person school this fall, a new KFF brief highlights the effects of the ongoing pandemic on the health and well-being of children, including missed routine vaccinations and preventive care, mental health challenges and economic setbacks that can influence health. There had been over 4 million COVID-19 cases among children as of July 29, 2021, with children comprising an increasing share of new cases due to the Delta variant. At the…

  • Implications of the Medicaid Fiscal Cliff for the U.S. Territories

    Issue Brief

    The U.S territories – American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) – have faced an array of longstanding fiscal and health challenges that were exacerbated by recent natural disasters and most recently by the COVID-19 pandemic. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. Congress is currently debating…

  • Temporary Enhanced Federal Medicaid Funding Can Soften the Economic Blow of the COVID-19 Pandemic on States, but is Unlikely to Fully Offset State Revenue Declines or Forestall Budget Shortfalls

    News Release

    The temporary boost in federal Medicaid funding enacted as part of the Families First Coronavirus Response Act (FFCRA) will soften the economic blow of COVID-19 on states, but is unlikely to fully offset state revenue declines or forestall budget shortfalls stemming from the pandemic, finds a new KFF analysis. The 6.2 percentage point increase in the Medicaid FMAP -- designed to provide states with broad fiscal relief, not just help with Medicaid costs -- is…

  • How Could the Build Back Better Act Affect Uninsured Children?

    Issue Brief

    This brief examines characteristics of uninsured children in 2020 and discusses how current policy proposals, including outreach efforts, continuous eligibility requirements, and closing the coverage gap, could affect children’s health coverage. Recent efforts to expand coverage for adults could benefit children’s coverage, especially for children in non-expansion states if the coverage gap is filled as proposed by the Build Back Better Act (BBBA).

  • COVID-19 Vaccination Rates Among Nursing Home Staff Have Risen by 25 Percentage Points Since the Biden Administration Announced a Vaccination Mandate for Health Care Workers Last Year

    News Release

    In a new analysis, KFF researchers find that COVID-19 vaccination rates among nursing home staff increased by 25 percentage points nationally (63% to 88%) from when the Biden administration announced the vaccine mandate for health care workers in August 2021 to after vaccination deadlines passed in March 2022. Researchers analyzed nursing home-level data from the federal government covering some 14,700 nursing homes, or about 97 percent of all nursing homes in the U.S. They conclude…

  • CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

    Issue Brief

    On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.

  • State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19

    Issue Brief

    As the COVID-19 pandemic continues, states have taken a number of Medicaid policy actions to address the impact on seniors and people with disabilities, many of whom rely on long-term services and supports (LTSS) to meet daily needs and are at increased risk of adverse health outcomes if infected with coronavirus.