Medicaid

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Medicaid work requirements

States Are Adopting a Variety of Outreach Strategies to Inform Individuals About Medicaid Work Requirements

Medicaid Work Requirements: Federal Outreach Requirements and State Plans

State Medicaid programs must inform people affected by new work requirements with federally required notices, and most states are planning other types of outreach, including phone calls, public ads, and social media posts. This brief describes the federal outreach requirements and state plans, as well as the complexities and tight implementation timelines states face.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies. The Congressional Budget Office estimates that the 2025 reconciliation law will increase the number of people who are uninsured in 2034 by 10 million. Coverage losses from Medicaid work requirements account for over half, or 5.3 million, of the increase in the number of uninsured.

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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • 4.7 Million Uninsured Adults Could Become Eligible for Medicaid by 2021 if All Remaining States Expanded the Program under the ACA

    News Release

    About 4.7 million uninsured adults could gain eligibility for Medicaid by 2021 if the 14 remaining non-expansion states were to expand Medicaid under the Affordable Care Act, a new KFF analysis finds. That figure includes an estimated 2.8 million adults who already were uninsured prior to the coronavirus pandemic and would fall in the “coverage gap” – meaning they have incomes too high to qualify for Medicaid but too low for ACA marketplace subsidies –…

  • Analysis Examines the Affordable Care Act’s Impact on Nearly All Americans

    News Release

    A week after the 2020 elections, the Supreme Court is scheduled to hear arguments on a legal challenge, supported by the Trump administration, that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. A KFF analysis examines key provisions of the 2010 law that have changed the nation’s health care system, including what’s…

  • Filling the Coverage Gap: Policy Options and Considerations

    Issue Brief

    This issue brief examines some of the other options policymakers may consider to extend coverage to people in the gap, including increased fiscal incentives for states, a narrower public option, and making people with incomes below the poverty level eligible for enhanced ACA premium subsidies.

  • What Are Some Policy Options for Reaching the 2.2 Million Uninsured People in the ACA’s “Coverage Gap”?

    News Release

    A new KFF issue brief explores several potential policy options that would help close the Affordable Care Act’s "coverage gap," including providing further new incentives for states to expand Medicaid, creating a new "public option" or extending ACA Marketplace premium subsidies to low-income people who don’t currently qualify for federal help. At stake is affordable health coverage for 2.2 million uninsured people with incomes below the federal poverty level ($12,880 annually for an individual in…

  • Medicaid and State Financing: Key Indicators to Watch Through Pandemic and Recovery

    Issue Brief

    The health and economic effects of the pandemic have significant implications for state Medicaid programs, as more people become eligible and enroll in Medicaid at the same time that states may face declines in revenues. This brief presents current data for key economic indicators to help understand how they could affect Medicaid enrollment and spending.

  • The Pandemic Has Exacerbated Long-Standing Health Care Challenges Faced By Puerto Rico and Other U.S. Territories as the End of Temporary Federal Medicaid Funding Approaches

    News Release

    A new KFF analysis examines how the coronavirus pandemic is affecting U.S. territories as well as issues related to the upcoming expiration of temporary Medicaid funding for the territories at the end of September. Prior to the pandemic, the U.S territories –– American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) -- faced an array of longstanding fiscal and health challenges that were exacerbated by…

  • Behavioral Health Crisis Response: Findings from a Survey of State Medicaid Programs

    Issue Brief

    Crisis behavioral health services provide access to trained mental health professionals for individuals experiencing mental health or substance use emergencies--an alternative to emergency departments and law enforcement. About three-quarters of responding state Medicaid programs do not cover all three core crisis services for FFS adults, but most states cover at least one core behavioral health crisis service. As crisis response systems continue to grow and expand, states are navigating a variety of concerns—including workforce shortages,…

  • New OIG Report Examines Prior Authorization Denials in Medicaid MCOs

    Policy Watch

    Congress asked the U.S Department of Health and Human Services (HHS) Office of the Inspector General (OIG) to investigate whether Medicaid MCOs are providing medically necessary health care services to their enrollees. OIG found that Medicaid MCOs had an overall prior authorization denial rate of 12.5%–more than 2 times higher than the Medicare Advantage rate. Prior authorization denial rates ranged widely across and within parent firms and states. After a prior authorization request is denied,…