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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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  • We’ve Never Seen Health Care Cuts This Big

    Perspective

    In this July 1 column for The New York Times Opinion section, KFF Executive Vice President for Health Policy Larry Levitt explains how the budget reconciliation bill passed by the Senate on July 1 is effectively a partial repeal of the Affordable Care Act (ACA) and, if signed into law, the resulting reductions in Medicaid and ACA Marketplace coverage would make it "the biggest rollback in federal support for health coverage ever."

  • 5 Key Facts About Medicaid and Veterans

    Issue Brief

    Medicaid helps fill gaps in coverage for veterans who are low-income, have disabilities, or are otherwise ineligible for military health benefits. It supports those with complex health needs and reduces out-of-pocket expenses. This brief presents five key facts about veterans with Medicaid and how policy changes in Congress could affect their coverage and access to care.

  • SCOTUS Ruling on Medina v. Planned Parenthood Will Limit Access to Care for Patients in South Carolina and Beyond

    Policy Watch

    The Supreme Court's ruling in Medina v. Planned Parenthood of the South Atlantic means that Medicaid enrollees in South Carolina, and in other states that exclude Planned Parenthood going forward, will not be able to use their Medicaid coverage to obtain any preventive services, such as contraceptive care, STI treatment and cancer screenings, at Planned Parenthood clinics.

  • Cost Sharing Requirements Could Have Implications for Medicaid Expansion Enrollees With Higher Health Care Needs

    Issue Brief

    This brief uses 2021 Medicaid claims data to examine utilization among Medicaid expansion adults and estimate how much cost sharing these enrollees could be required to pay under the new requirement if all states imposed the maximum cost sharing amounts. This is an illustrative analysis intended to describe which enrollees may be subject to the most cost sharing under the new provisions rather than estimate exactly what expansion enrollees may actually pay.

  • 5 Key Facts About Medicaid Coverage for People Living in Rural Areas

    Issue Brief

    This brief presents five key facts about Medicaid coverage among individuals living in rural areas. It draws on recent data to describe enrollment patterns, differences by state Medicaid expansion status, characteristics of the rural Medicaid population, and patterns of health care use among enrollees.