Medicaid

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.

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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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  • Children Discharged from Foster Care:  Strategies to Prevent the Loss of Health Coverage at a Critical Transition

    Report

    This report discusses the importance of maintaining health coverage for children who are discharged from foster care and presents strategies that state child welfare and Medicaid agencies can employ to reach this goal. In addition, the report also addresses the needs of children who age out of the foster care system at age 18, and discusses state options to expand health coverage to this group. Report

  • Section 1115 Waivers at a Glance:  Summary of Recent Medicaid and SCHIP Waiver Activity

    Other Post

    Section 1115 Waivers at a Glance: Summary of Recent Medicaid and SCHIP Waiver Activity This summary of waiver activity is part of the Commission's monitoring to provide information on how waivers are affecting the uninsured and the coverage provided to low-income Medicaid and SCHIP beneficiaries. It covers Section 1115 waivers submitted since August 2001. Report More information about the latest Section 1115 waiver activity, including some state fact sheets.

  • Section 1115 Medicaid and SCHIP Waivers: Policy Implications of Recent Activities

    Issue Brief

    This policy brief provides an overview of recent Section 1115 waivers and a discussion of key issues. The HIFA initiative, combined with state fiscal pressures, have led to an increase in the number of states seeking Section 1115 waivers. Many of these recent waivers stake out new ground in terms of the scope of changes in coverage that they permit.

  • Privatization of Public Hospitals

    Report

    This report examines the trends in the closure of public hospitals and their conversion to private ownership. It also provides case studies of communities where major privatizations have occurred. Report (.pdf) Summary of Findings (.pdf)

  • Enabling Services: A Profile of Medicaid Managed Care Organizations

    Report

    The report provides basic statistics on Medicaid managed care organizations providing enabling services - transportation, translation, education, and case management. The report also identifies the extent of variation across plans. REPORT Download

  • Immigrants’ Health Coverage and Access

    Report

    New and recent publications on immigrant health policy explore some of the complex problems the country faces in expanding health coverage to immigrants and provide basic statistics and facts on the current status of their health care. News Release: Recent Immigrants Have Had Little Impact on the Growth in America's Uninsured Population Issue Paper: Is Immigration Responsible for the Growth in the Number of the Uninsured? Fact Sheet: Immigrants' Health Care Coverage and Access Chart…

  • Access to Care for S-CHIP Adolescents

    Report

    The second in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that the five study states have not focused special attention on the unique service needs of this age group, such as risk assessment and counseling, reproductive and sexual health services, and mental health services, when designing their programs. REPORT Download