Medicaid

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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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  • CHIP TIPS: New Federal Funding Available to Cover Immigrant Children and Pregnant Women

    Issue Brief

    This brief examines a new option under the Children's Health Insurance Program Reauthorization Act of 2009 that allows states to receive federal funds for providing Medicaid and CHIP coverage to lawfully residing immigrant children and pregnant women regardless of when they entered the country. Previously, states had been prohibited from using federal Medicaid or CHIP funds to cover legal immigrants who had been in the country fewer than five years. The brief, the fifth installment…

  • State Medicaid Coverage of Family Planning Services: Summary of State Survey Findings

    Other Post

    State Medicaid Coverage of Family Planning Services: Summary of State Survey Findings Over the past two decades, Medicaid has played a central and growing role in financing and providing access to family planning services for low-income women. About two-thirds of women covered by Medicaid are of child-bearing age, and for this group of women, access to family planning services fills a key health need. This report highlights findings from the 2007/2008 State Survey of Reproductive…

  • Resources Examine Medicaid Enrollment Growth And State Budget Pressures

    Fact Sheet

    This package of resources examines the substantial enrollment growth in Medicaid between June 2008 and June 2009 and provides a mid fiscal-year 2010 update on key state Medicaid issues, including the impacts of the economic downturn. News ReleaseWith the country in a deep recession, nearly 3.3 million more people were enrolled in state Medicaid programs in June 2009 compared to the previous June, according to a new analysis, Medicaid Enrollment: June 2009 Data Snapshot (updated for…

  • Mobile Technology: Smart Tools to Increase Participation in Health Coverage

    Issue Brief

    As mobile technology advances and cell phone use continues to increase across demographic groups, there is significant potential to tap these technologies to facilitate enrollment in and retention of health coverage, in both the immediate term and as health reform is implemented. A brief produced in conjunction with The Children's Partnership examines how various tools and strategies, including text messages and smart phone apps, can be used to advance coverage goals. The report focuses especially…

  • Medicaid Matters: Understanding Medicaid’s Role in Our Health Care System

    Fact Sheet

    This fact sheet provides key information about the Medicaid program and its role in our health care system and state economies. The nation’s public health insurance program for low-income people is counter-cyclical, expanding during the recent recession to assist millions of individuals and families affected by the loss of jobs and job-based health insurance. While the program has worked as intended, economic conditions have contributed to growing pressure on state budgets and Medicaid funding. This…

  • A Guide to the Medicaid Appeals Process

    Issue Brief

    This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services, but the process is multi-layered and can be complex to navigate. The guide describes Medicaid's appeals system, including the fair hearing process and the appeals…

  • The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers

    Fact Sheet

    For many years, Section 1115 waivers have been used in the Medicaid program to provide states an avenue to test and implement coverage approaches that do not meet federal program rules, but there have been longstanding concerns about the lack of public input and transparency in the waiver approval process. As a result, the Affordable Care Act required the Department of Health and Human Services to issue regulations designed to ensure that the public has…

  • How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

    Issue Brief

    This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will be wide state variation. The paper presents data showing how states compare in their 2012 Medicaid fee levels, how Medicaid fees compared to Medicare fees,…

  • National Survey of Public Knowledge of Welfare Reform and the Federal Budget

    Poll Finding

    Survey Shows "Two Faces" Of Public Opinion On Welfare Reform Americans Support Time Limits and Tough Work Requirements, But Reluctant to Abandon Those In Need Public Defines Welfare Broadly Understands Key Details of Welfare Programs Embargoed for release: 9:00 a.m. EST, Thursday, January 12, 1995 For further information contact: Matt James or Tina Hoff Menlo Park, CA -- A new Kaiser/Harvard survey of Americans nationwide has found that the public supports strong welfare reform measures,…

  • An Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicare Drug Benefit

    Issue Brief

    An Update on the Clawback: Revised Health Spending Data ChangeState Financial Obligations for the New Medicare Drug Benefit States are obligated to finance part of the new Medicare prescription drug benefit via a monthly "clawback" payment to the federal government. This issue update analyzes the latest data and provides an overview of the state financing of the Medicare drug benefit. Revisions by the federal government due to updated data has resulted in an estimated net…