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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.

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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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • Brief Examines Per Enrollee Medicaid Spending for Seniors and People with Disabilities, Which Varies Greatly By State

    News Release

    Medicaid coverage of acute and long-term care for more than 6 million low-income seniors and 10 million nonelderly people with disabilities accounts for nearly two-thirds of overall Medicaid spending, although such enrollees represent less than a quarter of people on Medicaid.  Much of Medicaid’s spending on seniors and people with disabilities also depends on state decisions about whom to cover and which services to pay for, which is a big reason why Medicaid spending per…

  • Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

    Issue Brief

    While the future of legislation to repeal and replace the Affordable Care Act (ACA) and make fundamental changes to the structure and funding of the Medicaid program is uncertain, states and the Administration may achieve major changes to Medicaid through the use of Section 1115 Medicaid waivers. Wisconsin submitted a waiver amendment request to CMS in June 2017 and Maine submitted a waiver application to CMS in August 2017. Unlike previous waivers that encompass the…

  • No, Medicaid Isn’t Broken

    From Drew Altman

    With Medicaid about to be a focal point of debate in the Senate, Drew Altman's Axios column looks at why the idea that the program is broken is more urban legend than fact.

  • Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic

    Issue Brief

    This data note looks at state Medicaid managed care enrollment data through March 2021 to assess the impact of the COVID-19 pandemic and economic crisis on Medicaid enrollment. Data collected for 29 states show that the rate of Medicaid managed care enrollment growth was 18.8% when comparing managed care enrollment from March 2020 through March 2021. The rate accelerated compared to March 2020 through September 2020 and reversed the trend seen from March 2019 to…

  • Medicaid Spending and Enrollment Trends Amid the COVID-19 Pandemic – Updated for FY 2021 & Looking Ahead to FY 2022

    Issue Brief

    Even as the COVID-19 vaccine roll-out is accelerating across the country, the public health and economic effects of the pandemic continue to put pressure on Medicaid spending and enrollment. In mid-February 2021, the Kaiser Family Foundation (KFF) and Health Management Associates (HMA) fielded a two-part rapid, mini-survey of Medicaid directors in all 50 states and the District of Columbia as a follow-up to the annual Medicaid Budget Survey conducted last summer. This brief provides insights…

  • State Medicaid Home & Community-Based Services (HCBS) Programs Respond to COVID-19: Early Findings from a 50-State Survey

    Issue Brief

    This issue brief presents early findings from the most recent KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. It focuses on state policies adopted in response to challenges posed by the pandemic, the pandemic’s impact on Medicaid HCBS enrollees and providers, and states’ initial plans for the new American Rescue Plan Act 10 percentage point temporary increase in federal Medicaid matching funds for HCBS available from April 2021…

  • Direct Care Workforce Shortages Have Worsened in Many States During the Pandemic, Hampering Providers of Home and Community-Based Services

    News Release

    During the pandemic many states have experienced worsening direct care workforce shortages that have affected providers of home- and community-based long-term care services (HCBS), according to early findings of a new KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. Most states reported workforce shortages as the pandemic’s primary impact on HCBS provided in an enrollee’s home and in group homes. The pandemic has brought new attention among policymakers…

  • Understanding the Impact of Medicaid Premiums & Cost-Sharing: Updated Evidence from the Literature and Section 1115 Waivers

    Issue Brief

    Our review of recent literature on premiums and cost-sharing is based on studies and reports published between 2017 and 2021. Our analysis of premiums in post-Affordable Care Act (ACA) Section 1115 waivers (approved under the Obama and Trump administrations) is based on available interim and final waiver evaluations as well as annual and quarterly state data reports posted on Medicaid.gov.