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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.

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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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  • A Race to the Top: Illinois’s All Kids Initiative

    Report

    A Race to the Top: Illinois’s All Kids Initiative In the summer of 2006, Illinois launched All Kids, the nation’s first universal coverage program for children. Several states have observed Illinois’ experience and are proceeding with their own coverage initiatives. This case study of Illinois' All Kids initiative describes the key features of the program, examines state decisions on program design and highlights some early program experiences. Report (.pdf)

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Trends in Medicaid Physician Fees, 2003-2008

    Fact Sheet

    This study, published in a Health Affairs Web exclusive, provides the first national and state-by-state update of Medicaid physician fees since 2003. Medicaid has historically reimbursed physicians under fee-for-service at levels below what Medicare and private health insurers would pay for the same services. The study finds that Medicaid fees grew by more than 15 percent from 2003 to 2008, but fell in real terms because the gains did not keep pace with inflation. Medicaid…

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • Health Reform: Lessons From Massachusetts

    Event Date:
    Event

    As Congress debates comprehensive national health reform, the Kaiser Family Foundation has two reports and an updated fact sheet that examine state-level health reform in Massachusetts and the lessons it offers for policymakers in Washington. Consumers’ Experience in Massachusetts: Lessons For National Health Reform and In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts, examine the impact of health reform on the lives of ordinary people in the state, including…

  • Why Express Lane Eligibility Makes Sense for States and Low-Income Families

    Issue Brief

    Express Lane Eligibility (ELE) is a new tool available to states to streamline enrollment and renewal of children in Medicaid and CHIP. It allows state Medicaid and CHIP agencies to utilize data and eligibility findings from other public need-based programs, such as Head Start or Food Stamps, and/or tax return data to identify, enroll and recertify children rather than requiring them to re-analyze and determine eligibility under their own rules. This issue brief, one in…

  • State Medicaid Coverage of Perinatal Services: Summary of State Survey Findings

    Issue Brief

    The report examines state Medicaid program policies regarding coverage of pregnancy-related services. It details state-level Medicaid eligibility and enrollment policies for pregnant women, as well as scope of coverage for prenatal and screening services, delivery and post-partum care, educational classes and support services.

  • Inside Deficit Reduction: What It Means For Medicaid

    Event Date:
    Event

    This briefing, co-sponsored by the Alliance for Health Reform, the Kaiser Family Foundation, the Robert Wood Johnson Foundation and The SCAN Foundation, featured panelists discussing which deficit-reduction proposals affecting Medicaid might receive serious consideration by the congressional "super committee," as well as what kind of impact such changes would have on Medicaid enrollees, providers and state Medicaid programs. For more information, please visit the Alliance's event page. Full Video   Speakers for this session: The…

  • Quick Take: Geographic Variation in Dual Eligible Enrollment

    Fact Sheet

    Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs.  These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).  Dual eligibles are among the sickest and poorest individuals covered by Medicare and Medicaid and, as a group, account for a disproportionate…

  • A Focus Group with Medicaid Directors: As FY 2012 Ends, Looking Toward FY 2013

    Report

    This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid spending and enrollment trends, key Medicaid policy changes and federal health care reform implementation. At the time of the meeting, most states were wrapping up…