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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s 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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  • Medicaid Long-Term Services and Supports: Key Changes in the Health Reform Law

    Issue Brief

    This issue brief examines new opportunities under the health reform law for states to balance their Medicaid long-term care delivery systems by expanding access to Medicaid home and community-based services (HCBS) programs. The brief outlines key provisions of the new law that expand HCBS benefit options, broaden financial and functional eligibility criteria, and provide additional financial incentives for states to further shift their Medicaid long-term services budgets to non-institutional settings. Issue Brief (.pdf)

  • Hispanics and the New Medicare Drug Benefit

    Poll Finding

    In a few short weeks, Medicare will undergo big changes that will have a major impact on more than 3 million Hispanic seniors and younger people with permanent disabilities who rely on Medicare for their health coverage. More than one in three Hispanics with Medicare lack coverage for their prescription drugs for at least part of the year. Many others will need to make decisions about their existing coverage and the new Medicare benefit. Starting…

  • Special Needs Plans: Availability and Enrollment

    Report

    Special Needs Plans are a form of Medicare Advantage plan authorized to provide a managed care option for beneficiaries with significant or relatively specialized care needs, including Medicare beneficiaries who are dually eligible for Medicare and Medicaid, beneficiaries living in nursing homes or other institutions, and beneficiaries with severe chronic or disabling conditions. This data spotlight examines availability and enrollment trends for Special Needs Plans, which account for a small share of enrollment today but…

  • Medicaid and SCHIP Eligibility for Immigrants

    Fact Sheet

    Immigrants in the U.S. face increasing challenges securing health care coverage. They have less access to employer-sponsored insurance than native citizens and face tighter restrictions on their eligibility for Medicaid and SCHIP, the nation’s major public health coverage programs for low-income children and families. This fact sheet provides an overview of the current rules on immigrants' eligibility for Medicaid and the State Children's Health Insurance Program. Fact Sheet (.pdf)

  • State Medicaid Actions Related to the Passage of the Deficit Reduction Act: A Background Briefing for Reporters on the Latest Developments

    Fact Sheet

    The Deficit Reduction Act (DRA) of 2005 was signed into law in February 2006 with several significant changes to the Medicaid program affecting both health and long-term care coverage as well as new citizenship requirements. States were granted greater flexibility in charging copayments and premiums and modifying the benefit package for certain Medicaid beneficiaries. Changes of this type previously required a waiver and now can be done by amending the state plan. The first two…

  • State Fiscal Conditions and Health Coverage: An Update on FY2004 and Beyond

    Report

    The Kaiser Commission on Medicaid and the Uninsured released three new reports today on how states are coping with the fourth year of fiscal stress. The third annual survey of the 50 states reveals a far-reaching impact on health coverage for low-income families at a time when enrollment is increasing due to sluggish economic conditions. Some of the findings from the reports include: Medicaid spending growth slowed for first time in 7 years. For 2003…

  • Low-Income Medicare Beneficiaries: How the House and Senate Prescription Drug Bills Address Their Drug Needs

    Report

    The House and Senate versions of a Medicare prescription drug bill treat the drug costs of those dually-eligible for Medicare and Medicaid and other low-income Medicare beneficiaries quite differently. The Kaiser Commission on Medicaid and the Uninsured cosponsored a policy briefing on the key issues in the two bills that would impact low-income beneficiaries and released a brief and background report on the topic. A Prescription Drug Benefit in Medicare: Implications for Medicaid and Low-Income…

  • SCHIP Enrollment in 50 States: June 2005 Data Update

    Report

    This report finds that monthly SCHIP enrollment reached a record high of more than 4 million in June 2005, reversing the decline seen in the previous 12 month period. SCHIP enrollment rose in all but nine states, including large increase in California, Georgia, and Illinois. Report (.pdf)

  • Enrolling Uninsured Low-Income Children in Medicaid & SCHIP

    Fact Sheet

    This fact sheet outlines issues in outreach and enrollment for Medicaid and SCHIP. It provides a profile of eligible but uninsured children, discusses the greatest barriers to enrollment, and offers strategies to improve enrollment. Fact Sheet (.pdf)