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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  • Health Coverage For Low-Income Children.

    Fact Sheet

    Health Coverage For Low-Income Children This fact sheet profiles the low-income children population, describes sources of health insurance coverage for the population, and summarizes trends and issues about their health coverage. Fact Sheet (.pdf)

  • SCHIP Reauthorization: Key Questions in the Debate – A Description of New Administrative Guidance and the House and Senate Proposals – Issue Brief

    Issue Brief

    SCHIP Reauthorization: Key Questions in the Debate – A Description of New Administrative Guidance and the House and Senate Proposals The U.S. Senate and the House of Representatives have approved legislation to reauthorize the State Children's Health Insurance Program (SCHIP), which covers six million low-income children today. With the release of the Census health coverage numbers, this updated brief answers key questions that explain the ongoing policy debate about this public health coverage program, which…

  • 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…

  • Health Affairs Article: Beyond Incrementalism? SCHIP and the Politics of Health Reform

    Report

    This article examines the political and legislative history of the Children's Health Insurance Program and analyzes the lessons for policymakers who are contemplating broader health care reform. It was published online in the journal Health Affairs and was authored by Jonathan Oberlander, an associate professor, social medicine and health policy and management, at the University of North Carolina at Chapel Hill, and Barbara Lyons, a vice president of the Kaiser Family Foundation and deputy director…

  • 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…

  • Putting Children on the Express Lane to Health Insurance: Streamlining Enrollment and Renewal of Children in Medicaid and CHIP Through Express Lane Eligibility

    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. A primary goal of this…

  • 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.

  • Medicaid’s Continuing Crunch In a Recession: A Mid-Year Update for State FY 2010 and Preview for FY 2011

    Report

    This report finds that 44 states and the District of Columbia are experiencing higher than expected program enrollment and spending for fiscal year 2010. At least 29 states say they are considering additional mid-year cuts in provider rates and program benefits. The recession and the scheduled end on Dec. 31, 2010 of enhanced federal matching money for Medicaid that was provided through the American Recovery and Reinvestment Act of 2009 will have a significant impact…

  • Mental Health Financing in the United States: A Primer

    Report

    This primer provides an overview of behavioral health care, reviews the sources of financing for such care, assesses the interaction between different payers, and highlights recent policy debates in mental health. It also discusses the role of Medicaid, currently the largest source of financing for behavioral health services in the nation, covering a quarter of all expenditures. This comprehensive resource serves as a guide for those who want to understand the complex system of behavioral…