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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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  • State Budgets and Health Coverage:  An Update on FY 2004 and Beyond

    Other Post

    State Budgets and Health Coverage: An Update on FY 2004 and Beyond New reports released at a January 28, 2004 briefing updating a survey on Medicaid budget trends, the future fiscal outlook of states, and case studies of ten states and their budget conditions. Webcast of January 28, 2004 Briefing News Release Report: States Respond to Fiscal Pressure: A 50-State Update of State Medicaid Spending Growth and Cost Containment Actions Issue Brief: Is the State…

  • What Has Caused the Growth in Medicaid Spending in Recent Years?

    Event Date:
    Event

    A new study published in Health Affairs explains what caused Medicaid spending to rise from 2000-2003 and confirms the role Medicaid played in covering people during the recent economic downturn, and that Medicaid per enrollee spending grew at a slower rate than private insurance spending. The Kaiser Commission on Medicaid and the Uninsured and Health Affairs cosponsored a briefing to discuss the findings of the study. News Release Understanding the Recent Growth in Medicaid Spending,…

  • Key Facts: States Most Affected by Hurricane Katrina

    Fact Sheet

    Key Facts: States Most Affected by Hurricane Katrina A side-by-side comparison of key demographics and health coverage statistics of the states most affected by Hurricane Katrina. Fact Sheet (.pdf)

  • The Distribution of Assets in the Elderly Population Living in the Community

    Issue Brief

    Individuals cannot qualify for Medicaid nursing home care or home and community-based services unless they meet their state's asset eligibility standards. Currently, states are required to examine all transfers for less than fair market value that occurred within 36 months prior to an individual's application for Medicaid. This issue paper examines the assets of elderly people living in the community, focusing on those most at risk of using nursing home care. The paper finds that…

  • Unintended Consequences: The Potential Impact of Medicare Part D on Dual Eligibles with Disabilities in Medicaid Work Incentive Programs

    Report

    Individuals with disabilities who are eligible for both Medicare and Medicaid must also shift to a Medicare prescription drug benefit in 2006. This report analyzes how younger dual eligibles in Kansas enrolled in work incentive programs differ than other Medicare enrollees in the types of drugs they use and how much drug spending they have to better assess the impact of the Medicare drug benefit on this population. Report (.pdf)

  • Medicaid: Addressing the Future

    Event

    Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, testified before the U.S. Senate Special Committee on Aging on the future of Medicaid and its role for low-income Americans, particularly the elderly. Testimony (.pdf)

  • Dual Eligibles and Medicare Part D

    Issue Brief

    This snapshot summarizes the latest information and policy issues about the enrollment of dual eligibles into the Medicare prescription drug benefit. Issue Brief (.pdf)

  • Fact Sheets Summarize President’s Budget Proposals for Health Insurance Coverage, Including Medicaid and SCHIP

    Fact Sheet

    Fact Sheets Summarize President's Budget Proposals for Health Insurance Coverage, Including Medicaid and SCHIP The President's fiscal year 2008 budget proposal includes changes to Medicaid, provisions for the reauthorization of SCHIP, and the health coverage initiative, Affordable Choices. These fact sheets provide an overview of President Bush's policy plans on these health coverage issues. The Affordable Choices Initiative: An Overview President's FY2008 Budget and The State Children's Health Insurance Program President's FY 2008 Budget and…