Medicaid

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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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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  • What is the Centers for Medicare and Medicaid Services’ New AHEAD Model?

    Issue Brief

    In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced a new opportunity for states to leverage federal funding on health care: the Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. With this model, CMS – under the auspices of the CMS Innovation Center, also known as CMMI -- aims to reduce the rate of growth in health care spending, improve people's health, and reduce disparities in health outcomes. This issue brief…

  • What 2024 Could Bring for Working-Age Adults with Disabilities 

    News Release

    As the 25th anniversary of Olmstead nears, more than one-in-10 working age adults have a disability and most do not receive public disability income.  Over one-in-10 working-age adults reported having a disability in 2022. A disability is defined as having difficulty with hearing, vision, cognition, ambulation, self-care, or independent living, according to KFF's examination of data on people with disabilities from the American Community Survey. Fewer than a third of working-age adults with disabilities receive…

  • With More than Half of Medicaid Enrollees Awaiting their Renewal Process, New Report Highlights Lessons Learned that Can Inform State Efforts and Reduce Disenrollments for “Procedural” Reasons

    News Release

    At the beginning of 2024, nine months into states’ efforts to unwind the Medicaid continuous enrollment provision and reverify enrollees’ eligibility, states have completed renewals for less than half of all enrollees. To gain a better understanding of what challenges states are facing and the effects of different unwinding strategies, KFF interviewed state Medicaid officials in Arizona, Indiana, and Pennsylvania, as well as others involved, including representatives from Medicaid, managed care plans, legal aid organizations,…

  • Medicaid and State Financing: What to Watch in Upcoming State Budget Debates

    Issue Brief

    State legislatures are currently gathering to develop new budgets for state fiscal year (FY) 2025. Heading into this budget cycle, state fiscal conditions are shifting, with state revenues starting to decline following steep revenue growth during the pandemic. This issue brief examines trends in state fiscal conditions and discusses how state budgets and macroeconomic conditions may affect individuals and state Medicaid programs.

  • 10 Things to Know About Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs)

    Issue Brief

    In 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs). This brief highlights 10 things to know about D-SNPs, including national and state enrollment trends, plan availability, insurer participation, benefits, and prior authorization rates and denials

  • What Would Another Trump Presidency Mean for Health Care?

    Perspective

    In a new column in JAMA Health Forum, Larry Levitt, KFF’s executive vice president for health policy, explores what a second Trump presidency might mean for health policy based on his record and remarks, including potentially weakening the Affordable Care Act, reducing federal Medicaid costs, and restricting access to abortion.

  • Section 1115 Waiver Watch: Medicaid Pre-Release Services for People Who Are Incarcerated

    Issue Brief

    In April 2023, the Centers for Medicare and Medicaid Services (CMS) released guidance encouraging states to apply for a new Section 1115 demonstration opportunity to test transition-related strategies to support community reentry for people who are incarcerated. As of August 19, 2024, CMS has approved Section 1115 reentry waiver requests from 11 states, while 13 additional reentry waivers remain pending.