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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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  • Covering Uninsured Children: Reaching and Enrolling Citizen Children With Non-Citizen Parents

    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.…

  • Toplines — The Public’s Health Care Agenda for the New President and Congress

    Poll Finding

    Toplines -- The Public's Health Care Agenda for the New President and Congress This document contains the detailed toplines from The Public's Health Care Agenda for the New President and Congress poll. The poll involved a nationally representative random sample of 1,628 adults ages 18 and older who were interviewed by telephone between December 4 and 14, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points. For…

  • Chartpack — The Public’s Health Care Agenda for the New President and Congress

    Poll Finding

    Chartpack -- The Public's Health Care Agenda for the New President and Congress This chartpack provides the key findings from the survey of the public's attitudes regarding the health care agenda for President Obama and the new Congress in 2009. It assesses the relative priority placed on health care by the American public as part of addressing the economic recession and as a large scale reform issue. The public's priorities for health care reform and…

  • The Role of Medicaid in State Economies: A Look at the Research

    Issue Brief

    This policy brief synthesizes the results of 29 studies in 23 states that examine the role Medicaid plays in state and local economies. These studies estimate the economic stimulus derived from Medicaid spending, and also analyze the adverse effects on the state economy from reducing Medicaid spending. This policy brief provides an overview of Medicaid financing, explains the methods used to assess economic impact and summarizes the main findings from the research. Executive Summary (.pdf)…

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

    Report

    This report relays the perspective of leading state Medicaid directors to describe the fiscal strain on Medicaid and other safety-net programs as enrollment swells and state tax revenues shrink, raising the prospect of program cutbacks. It draws on focused interviews with leading Medicaid directors in November 2008. It augments the most recent Medicaid budget survey report that was based on a survey and interviews with all state Medicaid directors in July and August 2008, at…

  • Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees

    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…

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Making the Most of Medicaid: Promoting the Health of Women and Infants With Preconception Care

    Report

    This article examines the evolution and current role of Medicaid in improving access to preconception care for low-income women. It reviews Medicaid's eligibility policy and benefits of relevance to women of reproductive age, and discusses challenges facing the program. Authors Alina Salganicoff, vice president and director of women's health policy for the Kaiser Family Foundation, and Jane An, a research assistant at the Foundation, also examine potential opportunities to use the Medicaid program to promote…

  • Short Term Options for Medicaid in a Recession

    Issue Brief

    This policy brief discusses several short-term options for strengthening Medicaid at time when the economic recession has increased demand for the program and constrained state budgets. It details potential steps such as increasing federal funding, easing enrollment barriers and temporarily expanding coverage. Policy Brief (.pdf)

  • Health Coverage in an Economic Downturn: Impact of Tight Budgets on Families and States

    Fact Sheet

    The economic downturn has strained family finances and prompted some Americans to cut back on medications and forgo preventive care and visits to the doctor. At the same time, the downturn has triggered declines in tax revenue that inhibit states’ ability to meet rising Medicaid program costs as enrollment spikes during economic hard times. Many states are expected to struggle to close budget gaps despite moves by Congress and the Obama Administration to temporarily boost…