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Democrats ran on promises to roll back key Medicaid and ACA changes—and newly elected Democratic governors and legislators in several states could reignite ACA Medicaid expansion debates. Among the ten states that have not adopted the Medicaid expansion, Georgia, Kansas, Texas and Wisconsin are key states to watch for potential new debates about expansion given the outcome of the midterm elections.

Medicaid work requirements

Nebraska Renewal Outcomes Among Individuals Subject to Medicaid Work Requirements

Early Medicaid Work Requirement Insights From Nebraska

This brief describes the verification process for Medicaid work requirements in Nebraska and examines early data on outcomes for individuals subject to work requirements. Among Medicaid enrollees renewing coverage under Nebraska's work requirements, 93% met the requirements or qualified for an exemption —while 7% lost coverage.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies. The Congressional Budget Office estimates that the 2025 reconciliation law will increase the number of people who are uninsured in 2034 by 10 million. Coverage losses from Medicaid work requirements account for over half, or 5.3 million, of the increase in the number of uninsured.

understanding medicaid

Medicaid Financing: The Basics

Medicaid represents $1 out of every $5 spent on health care in the U.S. This brief examines key questions about Medicaid financing and how it works.

Medicaid and Provider Taxes

This brief explores how rules governing provider taxes are changing because of the 2025 reconciliation law and the regulations implementing that law, and summarizes which changes may affect each state.

5 Key Facts About Medicaid and Hospitals

This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid and how Medicaid expansion has impacted hospital finances.

Medicaid home Care

Medicaid Home Care/HCBS Survey

Since 2001, KFF has administered regular surveys of states about their Medicaid home- and community-based services (HCBS) programs. The survey is sent to officials administering Medicaid HCBS programs in all 50 states and the District of Columbia.

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  • 50 Million Uninsured: The Faces Behind the Headlines

    Event Date:
    Event

    Almost 50 million Americans lacked health insurance in 2010 -- about a million more than in 2009. Who are the uninsured? Why do so many Americans lack coverage? What are the trends in coverage among different segments of the population? What do these trends mean for the health care system and the costs of care? This briefing, co-sponsored by the Alliance for Health Reform and the Kaiser Family Foundation's Commission on Medicaid and the Uninsured,…

  • Impact of the Medicaid Fiscal Relief Provisions in the American Recovery and Reinvestment Act (ARRA)

    Issue Brief

    The American Recovery and Reinvestment Act (ARRA), enacted in February 2009, has provided $103 billion in federal fiscal relief to state Medicaid programs over a period of two-and-a-half years to help them address the effects of the 2007-2009 recession. During a recession, unemployment increases and state revenues decline, making it difficult for states to meet the increased demand for Medicaid coverage among the newly unemployed. This brief reviews the ARRA Medicaid fiscal relief provisions—how they…

  • Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider

    Issue Brief

    There is increased interest among states in operating Medicaid managed long-term services and support (MLTSS) programs rather than paying for long-term services and supports (LTSS) on a fee-for-service basis, as has been the general practice. This issue brief examines key issues for states to consider if they are contemplating a shift to covering new populations and LTSS benefits through capitated payments to traditional risk-based managed care organizations (MCOs). It draws on current literature as well…

  • State Options That Expand Access to Medicaid Home and Community-Based Services

    Report

    This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically have been for institutional, rather than home and community-based, services. Over the past two decades, major efforts have been undertaken by states and the Centers…

  • Medicaid’s Long-Term Care Users: Spending Patterns Across Institutional and Community-based Settings

    Issue Brief

    The nation's primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care…

  • California's "Bridge to Reform" Medicaid Demonstration Waiver

    Fact Sheet

    This issue brief provides an overview of California's "Bridge to Reform" Medicaid Demonstration Waiver, which was approved in 2010 and will make up to roughly $8 billion in federal Medicaid matching funds available to California over a five-year period to expand coverage to low-income uninsured adults and preserve and improve the county-based safety-net. The waiver also allows the state to enroll Medicaid-eligible seniors and persons with disabilities into managed care plans that meet specified readiness…

  • Connecting Eligible Immigrant Families to Health Coverage and Care: Key Lessons from Outreach and Enrollment Workers

    Issue Brief

    Beginning in 2014, health coverage options will significantly expand under health reform through an expansion in Medicaid eligibility and by making tax credits available to help individuals purchase coverage through new Health Benefit Exchanges. Given their high uninsured rate and limited access to private and public coverage, one group who could significantly benefit from this coverage expansion is lawfully residing immigrant families. However, it will be important to address barriers eligible immigrant families often face…

  • Update: State Budgets in Recession and Recovery

    Issue Brief

    State revenues have been rebounding after experiencing a severe decline caused by the Great Recession that ran from December 2007 through June 2009. Nevertheless, tax collections remain below their 2008 peak level and state and local governments continue to shed jobs. As states prepare their fiscal year 2013 budgets, some are projecting a fifth consecutive year of gaps between expected revenues and spending. This policy brief analyzes recent developments in state government finances and prospects…

  • A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey

    Report

    Most Medicaid beneficiaries nationally are enrolled in some form of managed care, and, with current budget pressure and health reform on the horizon, states are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey, conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access…

  • Inside Deficit Reduction: What it Means for Health Care

    Event Date:
    Event

    After much heated debate on the U.S. debt limit, the Budget Control Act of 2011 was passed on August 2, 2011, containing more than $900 billion in federal spending reductions over 10 years. The law also established the 12-person “super committee” charged with finding more than $1 trillion in additional savings. What exactly is called for in the law? What are the implications for health care programs, including Medicare, Medicaid, CHIP and the Patient Protection…