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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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  • Medicare Beneficiaries and Their Assets: Implications for Low-Income Programs

    Report

    This report, prepared by Marilyn Moon of The Urban Institute and Robert Friedland and Lee Shirey of Georgetown University's Center on an Aging Society, reviews the income and assets of the current Medicare population, provides an overview of asset tests used to determine eligibility for programs assisting low-income Medicare beneficiaries, and considers how alternative policy options would affect eligibility for these programs. The authors find that beneficiaries with low incomes tend to have minimal assets.…

  • Medicaid and Managed Care: Implications for Low-income Women

    Report

    This commentary reviews Medicaid's role for low-income women and examines the implications Medicaid managed care on the delivery of health services to this vulnerable population. Today 40% of the Medicaid population, mostly poor women and their children, is enrolled in managed care. Medicaid agencies are hoping managed care will control spending and address longstanding problems with access to care. Low-income women have a number of characteristics that make them doubly vulnerable to have trouble accessing…

  • Long-Term Care:  Medicaid’s Role and Challenges

    Issue Brief

    Long-Term Care: Medicaid's Role and Challenges This Policy Brief examines Medicaid's role in providing long-term care services. It describes long-term care services, the population that needs these services, and how people get long-term care services. It provides an overview of health insurance coverage of persons with long-term care needs and describes both Medicare's and Medicaid's role in providing these services. It also examines some of the policy issues and challenges involved in providing long-term care…

  • Medicaid and Prescription Drugs: An Overview

    Report

    This background paper discusses the coverage of prescription drugs through the Medicaid program. Some of the issues addressed include who is eligible to receive drugs, how drug coverage is paid for, and how much money states spend on drugs. Background Paper

  • Managed Care and Low-Income Populations in Florida: 1996-1998 Update

    Report

    This report, Managed Care and Low Income Populations in Florida: 1996-1998 Update, updates our 1996 case study of Florida's Medicaid managed care initiatives and their effect on low-income populations. The focus of this report is on how the program has matured and how it has affected access to care and the safety net. It is one of a series of reportsfrom the Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in…

  • Medicaid and Children: Overcoming Barriers to Enrollment

    Report

    Findings from a National Survey This national telephone survey of low-income parents represents a major effort to better understand the barriers to Medicaid enrollment and to test the usefulness of ideas to facilitate enrollment in a quantitative way. Examining both parents of uninsured children who appear eligible for Medicaid and parents with children currently enrolled in Medicaid, the survey findings present: a profile of low-income, Medicaid-eligible children; parents' Medicaid knowledge and perceptions; key barriers to…

  • Table

    Other Post

    SUMMARY OF CALIFORNIA VERSUS THE U KEY HEALTH CARE FACTS IN CALIFORNIA AND THE U.S. California U.S. Percentage uninsured (non-elderly) (1998) 24.4% 18.3% Percentage of children uninsured (1998) 20.8% 15.5% Percentage of non-elderly enrolled in Medicaid: 1998 11.1% 8.4% 1994 14.3% 10.0% Percentage of employers that offer health insurance (1999) 48% 61% Percentage of workers with access to coverage for "non-traditional" partners (1999) 31% 18% Average monthly HMO premium for family coverage (1999) $405 $445…