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An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid Work Requirements

Tracking 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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  • Medicaid and the Prescription Drug Benefit

    Issue Brief

    This policy brief includes background information on Medicaid and its drug benefit, provides examples of how states are using the cost containment mechanisms at their disposal and addresses issues surrounding beneficiary access to outpatient drugs. Policy Brief

  • Reaching Uninsured Children Through Medicaid: If You Build It Right, They Will Come

    Report

    This report analyzes enrollment data of recent years and draws on state experiences to outline the key strategies that will lead to successful enrollment in public health coverage programs and finds that improving enrollment in Medicaid drives improved overall enrollment into a state s public coverage programs. REPORT Download

  • The New Challenge of the Uninsured: Coverage in the Current Economy

    Event Date:
    Event

    Diane Rowland, executive director of the Commission, testified to the House Energy and Commerce Subcommittee on Health about health coverage for the uninsured in the current economy and discussed the special challenges of providing them coverage during uncertain economic times. Please note: the video is no longer available. If you have an urgent need for the video, you may contact us (choose “problem with video” on the form) and we will try to locate the…

  • Transitional Medical Assistance (TMA): Medicaid Issue Update

    Fact Sheet

    This fact sheet presents the key questions and answers regarding transitional medical assistance as a part of the Medicaid program and its relationship to Temporary Assistance to Needy Families (TANF), the welfare program. Fact Sheet

  • SCHIP Program Enrollment: June 2002 Update

    Report

    This report presents information on the number of children enrolled in SCHIP for each state, for specific months from 1998 to June 2002. As of June 2002, the SCHIP program covered 3.6 million low-income children. An increase of 571,000 from the previous June. REPORT Download

  • Proposed Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    This issue brief summarizes major provisions of the Notice of Proposed Rulemaking (NPRM) to modernize and strengthen federal Medicaid managed care regulations, which serves as an informational guide to key proposed new federal expectations and requirements of states and managed care arrangements, and federal oversight interests moving forward.

  • California’s Previously Uninsured After The ACA’s Second Open Enrollment Period

    Report

    The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracks the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. The second survey in…

  • Dual Eligible Demonstrations: The Beneficiary Perspective

    Issue Brief

    This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.

  • Median Medicaid/CHIP Income Eligibility Levels by Group

    Feature

    median-medicaid-chip-income-eligibility-thresholds-jan-2017 Download Source Based on  results from a national survey conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families, 2017.