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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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  • Poll: With More Than Half the Public Saying They or a Family Member Have Been Covered by Medicaid, Large Majorities Don’t Want Cuts, Including Most Trump Voters and Rural Residents

    News Release

    As Congress considers changes to the Medicaid program as part of the budget debate, relatively few (17%) in the public say they want to see a reduction in Medicaid spending, with larger shares saying they want spending to stay about the same (40%) or increase (42%), a new KFF Health Tracking Poll finds. Support for Medicaid spending cuts is relatively low even among traditionally conservative groups, including Republicans (33% favor cuts), people who voted for…

  • 5 Key Facts About Medicaid and Hospitals

    Issue Brief

    We explain the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.

  • Health Provisions in the 2025 Federal Budget Reconciliation Law

    Issue Brief

    On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).

  • Enrollment and Spending Patterns Among Medicare-Medicaid Enrollees (Dual Eligibles)

    Issue Brief

    This brief examines national and state-level data on enrollment and spending for Medicare-Medicaid enrollees using the 2019 and 2020 Medicare Beneficiary Summary Files and the 2019 Transformed Medicaid Statistical Information System (T-MSIS). Spending data for Medicare includes beneficiaries in traditional Medicare only, since spending data for beneficiaries enrolled in Medicare Advantage plans are unavailable. State-level data on Medicare-Medicaid enrollment and spending are available through KFF’s State Health Facts.

  • What Happens After People Lose Medicaid Coverage?

    Issue Brief

    This brief uses pre-pandemic data from the 2016-2019 Medical Expenditure Panel Survey (MEPS) to examine the extent to which people enroll in and retain other coverage during the 12 months following disenrollment from Medicaid/CHIP.

  • Medicaid as a Potential New Third Rail of US Politics

    Perspective

    In this JAMA Forum column, KFF's Larry Levitt examines Medicaid's growing political importance and the potential double whammy that could hit state Medicaid programs next year with the end of the COVID-19 public health emergency and a possible simultaneous recession.

  • State Policies Connecting Justice-Involved Populations to Medicaid Coverage and Care

    Issue Brief

    The COVID-19 pandemic has magnified pre-existing health disparities for justice-involved populations, with coronavirus infection rates among incarcerated populations higher than overall infection rates in nearly all states. Justice-involved individuals are disproportionately low-income and often have complex and/or chronic conditions, including behavioral health needs. Although the statutory inmate exclusion policy prohibits Medicaid from covering services provided during incarceration (except for inpatient services), states may take other steps to leverage Medicaid to improve continuity of care for…

  • Annual Survey of Medicaid Directors Finds States Continue to Adopt Policies to Respond to the Pandemic and Are Addressing Issues Related to Social Determinants of Health and Health Equity

    News Release

    More than 18 months into the COVID-19 pandemic, state Medicaid programs around the country continue to reshape policy in response to the public health emergency and at the same time advance broader initiatives and priorities, including efforts to address the social determinants of health and health equity, finds a new KFF survey. The 21st annual KFF survey of Medicaid directors in states and the District of Columbia highlights policies in place and changes implemented or…

  • Mental Health Parity at a Crossroads

    Issue Brief

    This brief discusses federal mental health parity protections -- what they are, who they apply to, who enforces them and key policy issues as Congress and federal agencies evaluate improvements to the law to address gaps in mental health coverage and access.