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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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    Issue Brief

    This issue brief illuminates the emotional and pocketbook struggles of families who have suffered financial reversals and lost health coverage in the economic recession forcing many to juggle bills, skip prescription medications and postpone visits to the doctor while they scramble to find a new job. Many who once had steady employment and incomes have had to turn to Medicaid and the State Children’s Health Insurance Program for the first time, even as those programs…

  • Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession

    Report

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  • Next Steps in Covering Uninsured Children: Findings from the Kaiser Survey of Children’s Health Coverage

    Issue Brief

    This issue brief provides key findings from the Kaiser Survey of Children's Health Coverage, including that many low- and middle-income working families with an uninsured child do not have access to employer-sponsored health insurance. The telephone survey of parents that was conducted in 2007 to learn more about children’s access to coverage and care and the health care cost-related pressures facing their families. Issue Brief (.pdf)

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    Issue Brief

    This issue brief examines health insurance coverage for low-income citizen children whose parents are not citizens and some of the specific barriers to enrolling these children in Medicaid and the State Children's Health Insurance Program. It is based on findings from the Kaiser Survey of Children's Health Coverage, a telephone survey of parents conducted in 2007 to learn more about children’s access to coverage and care and the health care cost-related pressures facing their families.…

  • Snapshots from the Kitchen Table: Family Budgets and Health Care

    Report

    This report from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) illustrates the financial struggles of many families in the United States and shows the central role of health care costs and coverage in a household's economic stability. The report, , is based on interviews with 27 families from six cities across the U.S.. It finds pervasive uncertainty over job security and households teetering on the financial brink, stretching to pay for…

  • States’ Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion

    Other Post

    States' Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion The Medicare Modernization Act (MMA) created a major new subsidy program for an estimated 14 million low-income Medicare beneficiaries that will provide assistance with their cost-sharing obligations under the Part D drug benefit. The MMA requires state Medicaid agencies, along with the Social Security Administration (SSA), to accept applications for the new low-income subsidy. MMA also specifies that people who…

  • Pulling it Together: The People Behind The Entitlement Debate

    Perspective

    Well before we have any clarity on the impact of the election on health reform, the pundits are handicapping the prospects of efforts to make a serious dent in the national debt and deficit.  Three national commissions are hammering out recommendations for reducing the debt and reining in entitlement spending, putting two giant health programs that serve the elderly, disabled and low-income Americans, Medicaid and Medicare, as well as Social Security, in the crosshairs of…

  • Survey of Georgia Residents on HIV/AIDS: Summary and Chartpack

    Report

    The public in Georgia, and particularly African Americans, are concerned about HIV/AIDS as a problem facing the nation. Most believe that the U.S. is losing ground when it comes to HIV/AIDS, and most would like to see the government increase spending to fight the disease in the U.S. This statewide representative survey examines Georgians views on the HIV/AIDS epidemic in their state and local communities, their knowledge and misconceptions about HIV/AIDS, Georgia's HIV testing rates,…

  • Missouri’s 2005 Medicaid Cuts: How Did They Affect Enrollees and Providers?

    Other Post

    Missouri's 2005 Medicaid Cuts: How Did They Affect Enrollees and Providers? This study, prepared for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured, examines the result of sweeping cutbacks that Missouri instituted in its Medicaid program in 2005 in response to state budget shortfalls. Researchers at the Urban Institute found that the number of uninsured people in the state increased, hospitals faced greater demand for uncompensated care and community health centers confronted revenue…