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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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  • Looking Ahead to the End of the Medicaid Continuous Enrollment Requirement

    Event Date:
    Event

    On Wednesday, March 16, 2022, KFF hosted a web briefing focused on the implications of the end of the PHE and the Medicaid continuous enrollment requirement. State Medicaid programs’ existing enrollment and renewal procedures, as well as their differing approaches to the unwinding of the continuous enrollment requirement, will have major impacts on Medicaid enrollment and broader health coverage trends.

  • Nursing Facility Staffing Shortages During the COVID-19 Pandemic

    Issue Brief

    This data note presents the most recent national and state-level data on nursing facility-reported staff shortages and describes the Biden Administration’s new policy initiatives to address staffing and other quality issues in nursing facilities.

  • States Look to Bolster Maternal Health

    Feature

    Starting April 1, states have a new option to extend Medicaid postpartum coverage from 60 days to 12 months without having to seek a waiver.

  • Medicaid: What to Watch in 2022

    Issue Brief

    As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.

  • The Intersection of Medicaid, Special Education Service Delivery, and the COVID-19 Pandemic

    Issue Brief

    The COVID-19 pandemic created unprecedented health and education challenges for children with disabilities, many of whom receive special education services. Many children receiving special education services have substantial health care needs, and services available through a child’s health insurance plan, such as Medicaid, can complement special education services. This brief explains how Medicaid and special education services intersect, explores the pandemic’s implications for children receiving special education services, and identifies key issues to watch moving…

  • What to Watch in Medicaid Section 1115 Waivers One Year into the Biden Administration

    Issue Brief

    Section 1115 demonstration waivers provide states an avenue to test new approaches in Medicaid and generally reflect changing priorities from one presidential administration to another. This issue brief summarizes waiver priorities and actions under the Biden Administration as well as pending waiver themes and other issues to watch. If the Build Back Better Act (BBBA) fails to pass or is narrowed significantly, Medicaid waivers and other administrative actions may be a key tool for the…

  • People With HIV in Non-Medicaid Expansion States: Who Could Gain Coverage Eligibility Through Build Back Better or Future Expansion?

    Issue Brief

    In this analysis, we explore the implications of the Build Back Better Act's current coverage provisions for people with HIV in select non-expansion states. We estimate the size of the population that could gain eligibility as well as their socio-demographic characteristics, examine their affordability barriers and assess the potential impact on the Ryan White HIV/AIDS Program. We also explore what Medicaid expansion could mean in these non-expansion states for people with HIV.

  • What Newly Released Medicaid Data Do and Don’t Tell Us

    What Newly Released Medicaid Data Do and Don’t Tell Us

    Policy Watch

    On February 14, 2026, CMS released a dataset with provider-level spending data that the agency suggests could be used to identify unusual billing patterns for specific services, states, or providers. This policy watch describes what the data include, what they exclude, and how they could potentially lead to mistaken conclusions given the limitations of the data.