Medicaid

new and noteworthy

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 Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • The Role of Section 1115 Waivers in Medicaid and CHIP: Looking Back and Looking Forward

    Issue Brief

    For many years, Section 1115 waivers have been used in the Medicaid program, and to a lesser degree in the Children’s Health Insurance Program, to provide states an avenue to test and implement coverage approaches that do not meet federal program rules. While these waivers have facilitated important program evolutions over time, some have also raised issues. This brief reviews the experience of Section 1115 Medicaid and CHIP waivers and discusses issues for the Obama…

  • Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

    Fact Sheet

    This fact sheet provides an overview of provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which was signed into law in February 2009. The Act extends and expands the State Children's Health Insurance Program (now referred to as CHIP, not SCHIP) that was enacted with bipartisan support a decade ago as part of the Balanced Budget Act of 1997 (BBA). Fact Sheet (.pdf) Fact Sheet: State Adoption of Coverage and Enrollment…

  • 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…

  • Report and Video Highlight Health Coverage Struggles, Other Economic Concerns of Working Families

    Event Date:
    Event

    This report and video from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) illustrate the financial struggles of many families in the United States and show the central role of health care costs and coverage in a household's economic stability. The report, Snapshots from the Kitchen Table: Family Budgets and Health Care, is based on interviews with 27 families from six cities across the U.S.. It finds pervasive uncertainty over job security…

  • The Adequacy of Health Insurance

    Event Date:
    Event

    Testimony by Diane Rowland, executive vice president and executive director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, at a congressional hearing, titled “Addressing Underinsurance in National Health Reform,” held Feb. 24, 2009, by a special task force of the Senate Committee on Health, Education, Labor, and Pensions. Rowland discussed the status of health insurance coverage in America and the gaps and limits to coverage that leave millions of Americans poorly protected…

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

    Video

    This Kaiser Family Foundation documentary, “Snapshots from the Kitchen Table: Family Budgets and Health Care,” profiles several American families who are struggling to make ends meet. It depicts the narrow financial ledge on which millions of low- and middle- income working households stand even in normal economic times, and illustrates the central role that health care costs and coverage play in a household’s economic stability. Some of the families profiled have health insurance, others do…

  • Rethinking Medicaid’s Financing Role for Medicare Enrollees

    Issue Brief

    This issue brief examines coverage of the nearly 9 million "dual eligible" beneficiaries, the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. It explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including having the federal government pick up the full cost of Medicare premiums, cost-sharing and gaps in Medicare-covered services and long-term care services for this population.…

  • 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…

  • Reports Analyze Cost and Coverage of People Eligible for Both Medicaid and Medicare and Options for Reforming Financing of Their Care

    Issue Brief

    These issue briefs examine coverage of the nearly 9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The reports explore the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, and provide state-level Medicaid spending and enrollment data related to this population. The policy options studied could collectively provide tens of billions of dollars in annual…