Medicaid

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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s 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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  • Covering the Low-Income Uninsured: The Case For Expanding Public Programs

    Issue Brief

    An article in the January/February 2001 issue of Health Affairs by Judith Feder, Larry Levitt, Ellen O’Brien, and Diane Rowland assesses how best to expand health insurance coverage for the low-income uninsured. The article concludes that despite flaws in existing public programs, which can and should be remedied, strengthening programs like Medicaid and CHIP establishes a foundation for truly effective coverage for all low-income Americans. Available at www.healthaffairs.org.

  • Health Affairs Article: Health Care in New Orleans Before and After Hurricane Katrina

    Issue Brief

    On the first anniversary of Hurricane Katrina’s landfall, a paper authored by Foundation staff, released as a web exclusive by the journal Health Affairs, examines the impact of the storm on New Orleans, the current state of health care in the city, and lessons learned about the city’s health care delivery system. Health Affairs article: Full Article Abstract

  • Helping Consumers Manage Long-Term Services and Supports in the Community: State Medicaid Program Activities

    Issue Brief

    The Medicaid program is a source for many innovative practices in making long-term services and supports (LTSS) available to consumers. Jointly financed by the states and the federal government, Medicaid pays for 40 percent of LTSS spending the United States. Case management services have been integral to Medicaid community-based LTSS programs since their inception, but as the programs have grown and evolved, particularly as options for care have increased and consumers have taken a more…

  • Medicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS’s March 23, 2012 Final Rule

    Issue Brief

    This brief provides a summary of the Centers for Medicare and Medicaid Services' (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan. 1, 2014, lays out procedures for states to implement the Medicaid expansion and the streamlined and integrated eligibility and enrollment system created under the ACA. Achieving this goal will require substantial process and system changes among state…

  • A Medicare Prescription Drug Benefit: Implications for Medicaid and Low-Income People

    Report

    The Senate and House of Representatives each approved legislation in June of 2003 that would establish outpatient prescription drug coverage for Medicare beneficiaries as part of Medicare program reform. Among the key differences in the House and Senate bills that still must be addressed are the treatment of Medicaid beneficiaries and the structure of low-income subsidy programs. The way in which these issues are resolved will have major implications for Medicaid beneficiaries, other low-income individuals,…

  • Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003

    Issue Brief

    Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003 This report provides the latest national and state data on Medicaid enrollment and spending for individuals enrolled in both Medicaid and Medicare, also knows as dual eligibles. Nationally, there are 7.5 million dual eligibles and while they comprise 14 percent of the Medicaid population, they account for 40 percent of Medicaid spending. Issue Paper (.pdf)

  • State Medicaid Outpatient Prescription Drug Policies:  Findings from a National Survey, 2005 Update

    Poll Finding

    State Medicaid Outpatient Prescription Drug Policies: Findings from a National Survey, 2005 Update This survey of state Medicaid pharmacy programs supplements surveys conducted in 2003 and 2000 and reports Medicaid prescription drug policies in effect in early 2005. It covers key elements of utilization management, drug purchasing and potential impacts of the implementation of the Medicare prescription drug benefit. Report (.pdf) Executive Summary (.pdf)