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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.

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  • Medicaid Matters For Low Income Medicare Beneficiaries: A Video

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    Event

    In this video, Mildred Benham, a 68 year-old dual enrollee who lives in Bloomington, Illinois, describes the role Medicaid plays in providing services that Medicare does not, such as prescription drugs and personal care. Mildred is a typical dual enrollee in that she has multiple conditions, such as fibrosis of the lungs, rheumatoid arthritis, high blood pressure, and cataracts. To control her conditions, she takes 12 prescriptions a day. Because of her physical limitations, Medicaid…

  • Medicare-Medicaid Policy Interactions

    Issue Brief

    Because over seven million elderly and disabled individuals are entitled to benefits under both Medicare and Medicaid, policy changes in one program not only affect both coverage and spending in the other but also impact access to services by individuals eligible for both programs. This primer summarizes two key policy interactions and includes a quick reference table of the most significant linkages between the two programs. Issue Brief (.pdf)

  • Reports Explore Long-Term Care Issues Included in the Deficit Reduction Act

    Issue Brief

    The Deficit Reduction Act (DRA) of 2005, which became law this February, includes several significant changes to Medicaid long-term care policies. The Kaiser Family Foundation's Commission on Medicaid and the Uninsured is releasing five new reports on long-term care issues that were addressed by the DRA changes. Long-term care accounts for 36 percent of Medicaid spending (over $100 billion annually) and is utilized by many of Medicaid's most costly beneficiaries, the low-income elderly and individuals…

  • Citizenship Documentation Requirements in The Deficit Reduction Act Of 2005:  Lessons From New York

    Report

    Citizenship Documentation Requirements in The Deficit Reduction Act Of 2005: Lessons From New York New York State is one of only four states in the nation that already requires documentation of citizenship for Medicaid applicants (the others are Georgia, Montana and New Hampshire), and the only state with significant implementation experience. New York’s citizenship documentation requirement has been in place since the mid-1970s, and provides a solid base of experience that can inform the implementation…

  • Medicaid Enrollment in 50 States: December 2001 Data Update

    Report

    This publication provides state-by-state enrollment information and identifies national trends from the data. Some of the findings include: The rate of Medicaid enrollment growth doubled during 2001. Overall enrollment increased in all 50 states and the District of Columbia, with positive enrollment growth in the categories of families, children and pregnant women as well as the aged and disabled. Data suggest that Medicaid continues to evolve from a welfare-based program to a more traditional health…

  • Medicare Prescription Drug Coverage: Facts, Options, and Implications

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    Testimony by Patricia Neuman, Sc.D., vice president and director of the Foundation's Medicare Policy Project, for the House Committee on Energy and Commerce, Subcommittee on Health, hearing on Creating a Medicare Prescription Drug Benefit: begins with a brief review of existing sources of prescription drug coverage for the Medicare population and a discussion of how the lack of coverage affects people on Medicare. It then reviews broad approaches to improving prescription drug coverage, considers the…

  • SCHIP Administration and Accountability

    Report

    The third in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that non-Medicaid S-CHIP programs faced more administrative challenges. Success with enrollment appeared primarily related to administrative decisions, including a lower band of S-CHIP income eligibility, and the lack of premiums. REPORT Download