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.

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  • Medicaid 101

    Feature

    This Health Policy 101 chapter explores Medicaid, the primary U.S. program providing comprehensive coverage of health care and long-term services and supports to about 80 million low-income people. Originating in 1965 and expanding with the Affordable Care Act, the chapter reviews Medicaid's evolution, including 2025 changes, and its joint federal and state financing and administration. It discusses how state-level flexibility in managing Medicaid leads to variation in coverage, spending, health care delivery, and access across…

  • The Impact of H.R. 1 on Two Medicaid Eligibility Rules

    Issue Brief

    This issue brief describes the impact of H.R.1's 10-year delay in implementing provisions in two Medicaid eligibility rules that would have reduced red tape. The delayed rules are projected to decrease federal spending and future Medicaid and CHIP enrollment and increase coverage loss.

  • Potential Story Lines from Trump-Era Health Care Cuts

    Perspective

    In his latest column for the JAMA Health Forum, KFF’s Larry Levitt talks about how popular shows like “The Pitt” can make changes to the health care system stemming from this year’s federal tax and budget bill tangible for viewers, and offers some suggested story lines.

  • 5 Key Facts about Medicaid’s Share of National Health Spending

    Issue Brief

    To provide historical context for how changes to Medicaid spending may impact national health spending trends, this brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.