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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  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Short Term Options for Medicaid in a Recession

    Issue Brief

    This policy brief discusses several short-term options for strengthening Medicaid at time when the economic recession has increased demand for the program and constrained state budgets. It details potential steps such as increasing federal funding, easing enrollment barriers and temporarily expanding coverage. Policy Brief (.pdf)

  • Making the Most of Medicaid: Promoting the Health of Women and Infants With Preconception Care

    Report

    This article examines the evolution and current role of Medicaid in improving access to preconception care for low-income women. It reviews Medicaid's eligibility policy and benefits of relevance to women of reproductive age, and discusses challenges facing the program. Authors Alina Salganicoff, vice president and director of women's health policy for the Kaiser Family Foundation, and Jane An, a research assistant at the Foundation, also examine potential opportunities to use the Medicaid program to promote…

  • Health Coverage in an Economic Downturn: Impact of Tight Budgets on Families and States

    Fact Sheet

    The economic downturn has strained family finances and prompted some Americans to cut back on medications and forgo preventive care and visits to the doctor. At the same time, the downturn has triggered declines in tax revenue that inhibit states’ ability to meet rising Medicaid program costs as enrollment spikes during economic hard times. Many states are expected to struggle to close budget gaps despite moves by Congress and the Obama Administration to temporarily boost…

  • President Obama’s Campaign Position on Health Reform and Other Health Care Issues

    Issue Brief

    During the 2008 Presidential campaign now President Barack Obama announced a comprehensive health care reform proposal and laid out his positions on a number of other key health care issues. The two documents below summarize these campaign policies and positions. They were prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc., and are based on information compiled from Obama's campaign Web site, speeches, campaign debates and news reports. They are…

  • Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year

    Report

    Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to expand access to community-based services and extend some services to a "moderate need" group for the first time to test the theory that early interventions…

  • Emerging Health Information Technology for Children in Medicaid and SCHIP Programs

    Report

    This report highlights states' innovative use of health information technology in their Medicaid and SCHIP programs to improve their ability to reach and enroll eligible children, improve the quality of care for children, increase communications with families, and continue to modernize their programs. Although many of these efforts are still in their early stages, findings to date indicate improvements in access to care, care coordination, case management, and administrative efficiency. States are pursuing ways to…

  • Low-Income Adults in New Orleans in 2008: Who Are They and How Are They Faring?

    Poll Finding

    Based on data from Kaiser's Second Post-Katrina Survey, this Survey Brief profiles low-income adults in New Orleans in 2008, examining their demographics, personal recovery from the aftermath of Hurricane Katrina, worries and concerns, and financial and health care challenges. It finds that low-income adults in New Orleans are more likely than other adults in the city to still be dealing with recovery from the aftermath of Hurricane Katrina and facing financial and health care challenges.…

  • Health Affairs Article: Florida’s Medicaid Reform: Informed Consumer Choice?

    Report

    Health Affairs Article: Florida's Medicaid Reform: Informed Consumer Choice? Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to make this health plan choice and over half of those who were aware reported difficulty making a plan choice, according to a Health Affairs…

  • Florida Medicaid Reform Waiver: Early Findings and Current Status

    Issue Brief

    Florida Medicaid Reform Waiver: Early Findings and Current Status This policy brief provides an overview of the Florida Medicaid reform and a summary of available research findings to date from various evaluators of the program. It was issued at the same time as a separate Health Affairs article highlighting findings from Kaiser Family Foundation's 2006-2007 Survey of Florida Medicaid Beneficiaries. The Foundation, in collaboration with the Urban Institute and the University of Florida, is conducting…