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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.

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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  • Unwinding of the PHE: Maintaining Medicaid for People with Limited English Proficiency

    Issue Brief

    Provisions in the Families First Coronavirus Response Act (FFCRA) require states to maintain continuous Medicaid enrollment for enrollees until the end of the month when the COVID-19 public health emergency (PHE) ends. When the continuous enrollment requirements end and states resume redeterminations and disenrollments, individuals with LEP may be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing these processes, even if they remain eligible for coverage.

  • Combined Federal and State Spending on Medicaid Home and Community-Based Services (HCBS) Totaled $116 billion in FY 2020, Serving Millions of Elderly Adults and People with Disabilities

    News Release

    The federal government and the states together spent a total of $116 billion on Medicaid home and community-based services (HCBS) in FY 2020, serving millions of elderly adults and people with disabilities, a new KFF analysis finds. Medicaid is the nation’s primary payer for such services, which include assistive technology, personal care to help people with bathing or preparing meals, and therapies to help people regain or acquire self-care and independent living skills. There is…

  • States Are Planning for the End of the Continuous Enrollment Requirement in Medicaid After the COVID-19 Public Health Emergency Expires, But Many Have Not Made Key Decisions

    News Release

    As states plan for the end of the COVID-19 public health emergency, the resumption of eligibility redeterminations and disenrollments when the continuous Medicaid enrollment requirement is lifted could lead to coverage disruptions and losses, according to a new KFF 50-state survey. The requirement, a condition of states receiving enhanced federal Medicaid funding during the pandemic, has helped drive Medicaid and CHIP enrollment to a record 85 million people, an increase of 19.1 percent since the…

  • Medicaid Managed Care Plans Can Help Enrollees Maintain Coverage as the Public Health Emergency Unwinds

    Issue Brief

    Throughout the pandemic, states have worked with managed care plans to respond to changing public health conditions and new developments. After the PHE ends, state Medicaid agencies will need to complete a large number of eligibility and enrollment tasks and actions, including processing renewals, redeterminations (based on changes in circumstance), and post-enrollment verifications. Medicaid managed care plans can assist state Medicaid agencies in communicating with enrollees, conducting outreach and assistance, and ultimately, in improving coverage…

  • Community Health Centers Are A Key Source of COVID-19 Rapid At-Home Self-Tests For Hard-To-Reach Groups

    Policy Watch

    As part of an effort to promote equitable access to tests, the Biden administration launched a testing supply program that has set aside 25 million rapid at-home self-test kits for distribution by community health centers. Under the program, health centers will be distributing self-tests to patients and community members, with a focus on populations at greatest risk from adverse outcomes related to COVID-19.

  • Nursing Home Staff Vaccination Rates Vary Widely by State as Vaccination Mandates Take Effect

    Issue Brief

    Due to the disproportionate impact of COVID-19 on nursing home residents and staff, this population was prioritized to receive the vaccine when the vaccine rollout began in Winter 2020-2021. Since then, CMS has implemented a health care worker vaccination mandate for providers that participate in Medicare and/or Medicaid. Although some states have sued to challenge this rule, it was recently allowed to take effect by the Supreme Court. This data note presents completed vaccination and…

  • Federal Policy May Temporarily Close the Coverage Gap, But Long-term Coverage May Fall Back to States

    Policy Watch

    Recent policy attention has focused on closing the coverage gap for roughly 2.2 million individuals living in the 12 states that have not adopted Medicaid expansion included in the Affordable Care Act (ACA). These individuals do not qualify for Medicaid and have incomes below poverty, making them ineligible for premium subsidies in the ACA Marketplace. Pending federal legislation may temporarily provide coverage to individuals in the coverage gap, but providing a permanent pathway to coverage may fall back…

  • Medicaid Enrollment Patterns During the Postpartum Year

    Issue Brief

    A provision in the American Rescue Plan Act (ARPA) of 2021 gives states a new option to extend Medicaid postpartum coverage to 12 months via a state plan amendment. This new option took effect on April 1, 2022 and is available to states for five years. Using Medicaid claims data from 2018, this brief examines enrollment patterns in the year following childbirth.

  • Medicaid Administrative Data: Challenges with Race, Ethnicity, and Other Demographic Variables

    Issue Brief

    There are persistent disparities in health and health care for people of color, which reflect structural and systemic inequities rooted in racism and discrimination. High-quality comprehensive data are key to enabling policymakers, community leaders, and other key stakeholders to identify and address these inequities and measure progress over time. Medicaid/CHIP administrative data, also known as Transformed Medicaid Statistical Information System (T-MSIS) or TAF (T-MSIS Analytic File), hold the potential to inform disparities research through detailed…