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An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid 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. 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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  • Ensuring Access to Care in Medicaid Under Health Reform

    Issue Brief

    This paper examines the key issues raised in a December 2010 roundtable discussion of federal and state officials and experts convened by the Kaiser Commission on Medicaid and the Uninsured to examine important issues related to ensuring access to care in Medicaid under the Patient Protection and Affordable Care Act (ACA). The ACA expands Medicaid to reach millions of low-income uninsured Americans and, recognizing current serious access problems system-wide, takes significant steps to build capacity…

  • Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries

    Issue Brief

    This issue brief identifies the major provisions in the Patient Protection and Affordable Care Act (ACA) that are designed to improve care and streamline service delivery for dual eligibles, the millions of low-income seniors and younger persons with disabilities who are enrolled in both the Medicaid and Medicare programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs; they comprise only 15 percent of total Medicaid enrollment…

  • Medicaid’s Role for Dual Eligibles

    Issue Brief

    These short profiles illustrate the help that Medicaid provides to four individuals who qualify for both Medicaid and Medicare. They include a 66-year-old former nurse who suffers from a multitude of health problems; an 86-year-old stroke survivor and nursing home resident; a 64-year-old man with disabilities who lives independently; and a 42-year-old woman with numerous chronic conditions, including diabetes, a thyroid condition, effects of a stroke, and depression. There are 9 million "dual eligibles" --…

  • Most Americans Oppose Converting Medicaid to a Block Grant in Order to Reduce the Federal Deficit

    News Release

    New Poll Finds Support For Medicaid May Be Linked to Broad Ties To The Program, With Half of Americans Reporting A Personal Connection 1 in 5 Adults Has Received Medicaid Benefits Over Time, And For Most, Experiences Were Positive, Although One Third Of Them Report Having Had Problems Finding A Doctor MENLO PARK, Calif. -- Most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and more than…

  • May Kaiser Health Tracking Poll: Views of Health Reform Law Remain Unchanged

    Perspective

    This month’s Kaiser Health Tracking Poll reveals little change in public opinion about the health reform law. Americans remain divided overall, with 42 percent having a favorable opinion of the law and 44 percent viewing it unfavorably. Three in ten continue to want to see the law expanded, while roughly one in five want it either kept as is (21%), repealed and replaced with a GOP alternative (19%), or repealed outright (19%). Americans continue to…

  • Pulling It Together: Predictions

    Perspective

    I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS.  One reason for this is the lingering effect of the recession.  Employers will have little trouble attracting workers in the…

  • A Medicaid Block Grant Would Reduce Federal Spending But Trigger Substantial Cuts in Medicaid Coverage in the States That Would Increase the Uninsured

    News Release

    NEWS RELEASEMay 10, 2011 New State-By-State Analysis Shows House Budget Plan For Medicaid Would Reduce Enrollment By Tens of Millions Of People And Cut Funding For Hospitals And Other Medicaid Services WASHINGTON, D.C. -- Converting Medicaid into a block grant and repealing the health reform law as adopted by the House last month in a party-line vote would trigger major reductions in program spending and enrollment compared to current projections, a shift with big implications…

  • Medicaid Financing Issues: Provider Taxes

    Fact Sheet

    Current law allows states to use revenue from provider taxes to help fund the state share of spending on Medicaid, a program that is jointly financed by the states and the federal government. Almost all states have at least one provider tax in place. This issue brief reviews the use of provider taxes by states as a mechanism for financing the state share of Medicaid spending. It also explores the implications of recent proposed changes…

  • Kaiser Health Tracking Poll — May 2011

    Feature

    Most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and more than half want to see no reductions at all in Medicaid spending. One in five adults has received Medicaid benefits over time, and for most, experiences were positive, although one third of them report having had problems finding a doctor. The findings come at a time of intense public debate in Washington about the future of…

  • Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    This updated fact sheet describes the nearly 8.9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and what the new health reform law may mean for them. Fact Sheet (.pdf)