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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s 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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  • Massachusetts Health Care Reform: Six Years Later

    Issue Brief

    In 2006, then-Gov. Mitt Romney signed Massachusetts' comprehensive health reform designed to provide near-universal health insurance coverage for state residents. Building on a long history of health reform efforts, the state embarked on an ambitious plan to promote shared individual, employer, and government responsibility. This brief examines Massachusetts' experience with coverage and access to care over the last six years, as well as the state's ongoing efforts to deal with persistent high health-care costs. The…

  • New Medicare Drug Benefit’s Impact on States and Low-Income Beneficiaries

    Other Post

    New Medicare Drug Benefit's Impact on States and Low-Income Beneficiaries The recently signed Medicare prescription drug bill transfers responsibility for providing prescription drug coverage to dual-eligible beneficiaries from Medicaid to Medicare and creates a new subsidy program for low-income Medicare beneficiaries. These changes will have a major impact on state Medicaid programs both fiscally and administratively and it will also mean major changes for low-income beneficiaries' drug coverage. Presentation: Medicare Prescription Drugs and Low-Income Beneficiaries…

  • Beyond Cash and Counseling: The Second Generation of Individual Budget-Based Community Long-Term Care Programs for the Elderly

    Report

    States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. Beginning in January 2007, a new provision in the Deficit Reduction Act of 2005 (DRA) allows states to offer an individual budget option for an expanded range of home- and community-based services in their Medicaid state plans…

  • Medicaid Financing Briefing – April 19, 2004

    Other Post

    On April 19, 2004 the Kaiser Commission on Medicaid and the Uninsured held a Washington policy briefing on the basics of Medicaid financing. A webcast and transcript of the briefing are available. Presentation Slides (.pdf) The publications below provide background information on Medicaid financing and the latest on Medicaid waiver activity. Reports related to Medicaid Financing and State Budgets Financing the Medicaid Program: The Many Roles of State and Federal Matching Funds Current Issues in…

  • Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Report

    This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and fraud and abuse. Report (.pdf)

  • Implications of the New Medicare Prescription Drug Benefit for State Medicaid Budgets

    Issue Brief

    For a number of years, Governors and other state policymakers have maintained that Medicare - rather than state Medicaid programs - should play the key role in providing prescription drug coverage to Medicare beneficiaries, including those who also qualify for Medicaid because they are impoverished and/or have extensive health care needs (i.e, the "dual eligibles"). Although the new Medicare prescription drug benefit law shifts drug coverage for dual eligibles from Medicaid to Medicare, it does…

  • Medicaid and Other Public Programs for Low-Income Childless Adults:  An Overview of Coverage in Eight States

    Report

    Medicaid and Other Public Programs for Low-Income Childless Adults: An Overview of Coverage in Eight States This report profiles childless adult programs in eight state-level jurisdictions: the District of Columbia, Maine, Massachusetts, Minnesota, New York, Oregon, Pennsylvania, and Washington. Report (.pdf) Background State Reports prepared by the Economic and Social Research Institute