Medicaid

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.

Dual Eligibles

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  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • State-Specific Section 1115 Waiver Fact Sheets

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured is closely following waiver activity to provide information on how these waivers are impacting the uninsured and affecting Medicaid and SCHIP and the coverage provided to low-income beneficiaries. Tennessee Section 1115 Waiver Amendment Proposal Fact Sheet California Section 1115 Waiver Fact Sheet Colorado Section 1115 Waiver Fact Sheet Delaware Section 1115 Waiver Fact Sheet Illinois Section 1115 Waiver Fact Sheet Maine Section 1115 Waiver Fact Sheet New…

  • 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,…

  • Making Medicaid Managed Care Work:  An Action Plan for Persons Living with HIV

    Other Post

    Making Medicaid Managed Care Work: An Action Plan for Persons Living with HIV This report, by the National Association of People with AIDS (NAPWA) with support from The Kaiser Family Foundation, describes nine key points for people living with HIV to keep in mind when trying to influence the development of a managed care system that will serve them effectively. Senator John Chafee (R-RI), an acknowledged ally of NAPWA, gratefully accepted the report upon its…

  • 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…

  • New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility?

    Issue Brief

    A few recent state Medicaid initiatives have emerged that take the program into new directions. States have expressed a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and, in some cases, relying more heavily on the private marketplace. In addition, states have sought to shape their initiatives in ways that could help them better predict and limit their exposure to costs. This brief…

  • Medicaid’s Role in Long-Term Care: Q & A

    Fact Sheet

    Financing long-term care for the nearly 10 million Americans who need services and support to assist them in life’s daily activities continues to challenge the nation. While Medicaid is the nation’s major source of financing for long-term care services, paying for over 40% of total long-term care, its role is not well understood. Misperceptions on who qualifies and what is covered are common. A new question and answer fact sheet about Medicaid’s long-term care assistance…

  • Health Coverage and Access Challenges for Low-Income Women

    Issue Brief

    This issue brief examines low-income women’s health insurance coverage, experience with health plans and providers, and access to care. The analysis is based on data from the 2001 Kaiser Women’s Health Survey, a nationally representative survey of nearly 4,000 women between the ages of 18 and 64. Issue Brief (.pdf)

  • Two New Reports Show Progress On Health Coverage Is Threatened As States Continue To Face Growing Pressures To Control Costs

    Report

    Two New Reports Show Progress on Health Coverage is Threatened as States Continue to Face Growing Pressures to Control Costs Two new KCMU 50-state surveys show states continue to face budget pressures that could limit public coverage. One survey shows all states plan more Medicaid cost-containment actions in FY2005 and the second shows that after recent gains, securing Medicaid and SCHIP coverage is more difficult for low-income families in 23 states. News Release The Continuing…