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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  • Implications of the New Medicare Prescription Drug Benefit for State Medicaid Budgets

    Issue Brief

    For a number of years, Governors and other state policymakers have maintained that Medicare - rather than state Medicaid programs - should play the key role in providing prescription drug coverage to Medicare beneficiaries, including those who also qualify for Medicaid because they are impoverished and/or have extensive health care needs (i.e, the "dual eligibles"). Although the new Medicare prescription drug benefit law shifts drug coverage for dual eligibles from Medicaid to Medicare, it does…

  • Making Sense of Recent Estimates of Eligible but Uninsured Children

    Issue Brief

    As Congress reauthorizes the State Children’s Health Insurance Program (SCHIP), accurate estimates of the number of children who are eligible for Medicaid and SCHIP but remain uninsured are critical for policy and budget development. The Congressional Budget Office (CBO) concluded that there are between 5 and 6 million children who are uninsured and eligible for Medicaid and SCHIP. CBO’s assessment is in sharp contrast to estimates released recently by the Bush Administration that indicating there…

  • Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees

    Issue Brief

    This issue brief illuminates the emotional and pocketbook struggles of families who have suffered financial reversals and lost health coverage in the economic recession forcing many to juggle bills, skip prescription medications and postpone visits to the doctor while they scramble to find a new job. Many who once had steady employment and incomes have had to turn to Medicaid and the State Children’s Health Insurance Program for the first time, even as those programs…

  • Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession

    Report

    This report relays the perspective of leading state Medicaid directors to describe the fiscal strain on Medicaid and other safety-net programs as enrollment swells and state tax revenues shrink, raising the prospect of program cutbacks. It draws on focused interviews with leading Medicaid directors in November 2008. It augments the most recent Medicaid budget survey report that was based on a survey and interviews with all state Medicaid directors in July and August 2008, at…

  • States’ Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion

    Other Post

    States' Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion The Medicare Modernization Act (MMA) created a major new subsidy program for an estimated 14 million low-income Medicare beneficiaries that will provide assistance with their cost-sharing obligations under the Part D drug benefit. The MMA requires state Medicaid agencies, along with the Social Security Administration (SSA), to accept applications for the new low-income subsidy. MMA also specifies that people who…

  • Health Care and the 2004 Elections: Health Care for Americans with Disabilities

    Issue Brief

    Health Care for Americans with Disabilities Download a printable .pdf of Health Care and the 2004 Elections: Health Care for Americans with Disabilities. IssueBackgroundHealth CoveragePrescription Drugs Under Public ProgramsCoverage of Long-Term Services and SupportsFinancing Medicaid and MedicareAssessing Candidate Positions Issue More than 50 million individuals, or roughly one in five Americans, have a disability. Diverse in health-care needs, levels of functioning, goals, and life circumstances, many count on Medicaid and Medicare to provide coverage for…

  • Pulling it Together: The People Behind The Entitlement Debate

    Perspective

    Well before we have any clarity on the impact of the election on health reform, the pundits are handicapping the prospects of efforts to make a serious dent in the national debt and deficit.  Three national commissions are hammering out recommendations for reducing the debt and reining in entitlement spending, putting two giant health programs that serve the elderly, disabled and low-income Americans, Medicaid and Medicare, as well as Social Security, in the crosshairs of…

  • Optimizing Medicaid Enrollment: Spotlight on Technology – Using Schools and Data Matching to Enroll Kids in Medicaid and CHIP

    Issue Brief

    This brief examines efforts by the Chicago Public School system to use multiple strategies including data matching with the school lunch program, marketing and local organizing to target children for outreach and enrollment in public health insurance and other benefits. It is the third brief in a Spotlight on Technology series profiling several states' innovative applications of technology to Medicaid enrollment efforts. The series illustrates a range of approaches that states can adopt to improve…