Medicaid

Work Requirements

Challenges Implementing Work Requirements

To better understand how states are preparing for Medicaid work requirements, states were asked to discuss anticipated challenges to implementing work requirements by the end of 2026, including related system changes and data matching.

Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

The Essentials
  • 5 Facts: Immigrants and Medicaid

    This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.
  • 5 Facts: Medicaid and Hospitals

    This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.
  • Medicaid Financing: The Basics

    Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.
  • 5 Facts: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.
  • 5 Facts: Medicaid and Nursing Facilities

    The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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  • A Look at Substance Use Disorders (SUD) Among Medicaid Enrollees

    Issue Brief

    In its role as a public program and the single largest payer of behavioral health services in the country, Medicaid is particularly well positioned to implement policy to improve the delivery, quality, and effectiveness of behavioral health services. Our analysis finds that 7.3 percent of Medicaid enrollees ages 12 to 64 had at least one clinically-identified substance use disorder in 2019, but this is likely an undercount, as other research suggests that prevalence is at least 4 times higher. People with clinically-identified SUD were more likely to be male, White, over 25 years old, and qualify for Medicaid based on a disability or through Medicaid expansion. Rates of clinically-identified SUD vary across states not only because of prevalence, but also because of other factors, such as provider screening behavior and variation in Medicaid coverage of services. National recommendations instruct providers to screen for substance use and conduct brief interventions for adults 18+, yet there may be gaps between SUD screening and referral. Other factors--such as patient privacy concerns or few healthcare visits--may also play a role in low identification of SUD.

  • Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Prepare for the Unwinding of the Pandemic-Era Continuous Enrollment Provision

    Report

    The 21st annual survey of state Medicaid and CHIP program officials conducted by KFF and the Georgetown University Center for Children and Families in January 2023 presents a snapshot of actions states are taking to prepare for the lifting of the continuous enrollment provision, as well as key state Medicaid eligibility, enrollment, and renewal policies and procedures in place as of January 2023. The report focuses on policies for children, pregnant individuals, parents, and other non-elderly adults whose eligibility is based on Modified Adjusted Gross Income (MAGI) financial eligibility rules.

  • 5 Key Facts About Medicaid and Provider Taxes

    Issue Brief

    As Congress weighs potential cuts in federal Medicaid spending through budget reconciliation, one option under consideration is to limit the use of state taxes on providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe states’ current provider taxes and the federal rules governing them.

  • Do State Decisions to Prioritize Renewals for Medicaid Enrollees Who are Likely Ineligible Affect Early Disenrollment Rates?

    Policy Watch

    Some states are prioritizing Medicaid renewals for enrollees flagged as likely to be ineligible. Early data from Arizona, Idaho, and Pennsylvania show disenrollment rates for flagged enrollees are higher than for other enrollees. This analysis considers why different state approaches to renewals may explain some – but not all – variation in disenrollment rates across the U.S.

  • Understanding Medicaid Procedural Disenrollment Rates

    Policy Watch

    State Medicaid unwinding data show procedural disenrollment rates are high across most states. This policy watch provides insights for interpreting the data and describes steps the Centers for Medicare and Medicaid Services (CMS) and states are taking to reduce procedural disenrollments.