Medicaid

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.

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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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  • One State’s Medicaid Managed Care Formulary Operations:  A Look at Pennsylvania, 2001-2002

    Report

    One State’s Medicaid Managed Care Formulary Operations: A Look at Pennsylvania, 2001-2002 This report examines formulary implementation under mandatory Medicaid managed care in Pennsylvania between 2001 and 2002. It looks at one state during a yearlong period; formulary operations are likely to vary across states and programs and over time. The report includes findings about Pennsylvania’s formulary operation and observations about improving the system. Report (.pdf)

  • Current Issues in Medicaid Financing

    Report

    In recent years there has been much discussion about states’ use of creative financing to draw down additional federal funds for Medicaid financing. Some suggest a curb on these practices and the President’s FY2006 budget includes provisions targeting intergovernmental transfers (IGTs). The Commission has produced a fact sheet and briefs on Medicaid financing issues. Medicaid Financing Issues: Intergovernmental Transfers and Fiscal Integrity - An Overview of IGTs, UPLs, and DSH - Issue Brief Medicaid's Federal-State…

  • Stresses to the Safety Net:  The Public Hospital Perspective

    Report

    The nation’s safety net financing is fragmented; consequently, providers must knit together resources from many different funding sources to create a stream of revenue to cover the costs of providing a very broad range of services. This report describes those sources of revenue, documenting that nearly 40% of all safety net revenues are from Medicaid. The report also describes challenges that safety net hospitals and health systems are experiencing as they attempt to rebound from…

  • Women and Health Care: A National Profile – Report

    Report

    Report - Women and Health Care: A National Profile Women and Health Care: A National Profile is a nationally representative telephone survey of 2,766 women ages 18 and older. A shorter companion survey of 507 men was also conducted. Full Report (.pdf) Report Highlights (.pdf) Introduction and Methods (.pdf) Chapter 1: The Demographics of Women (.pdf) Chapter 2: The Health of Women (.pdf) Chapter 3: Women and Health Insurance Coverage (.pdf) Chapter 4: Women's Access…

  • Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    This updated fact sheet describes the nearly 8.9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and what the new health reform law may mean for them. Fact Sheet (.pdf)

  • Home Transition Programs: Perspectives of Medicaid Care Planners

    Report

    Home Transition Programs: Perspectives of Medicaid Care Planners This report draws on interviews with Medicaid care planners for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences. Report (.pdf)

  • Understanding the Recent Changes in Medicaid Spending and Enrollment Growth Between 2000-2004

    Report

    This report analyzes Medicaid enrollment and spending trends for the years 2000-2004. Rising enrollment and health care inflation produced most of Medicaid's spending increases during the period. Even with a stronger economy, however, Medicaid's enrollment pressures remain due to demographic trends and continued declines in employer sponsored insurance. Report (.pdf)

  • Health Coverage For Low-Income Children.

    Fact Sheet

    Health Coverage For Low-Income Children This fact sheet profiles the low-income children population, describes sources of health insurance coverage for the population, and summarizes trends and issues about their health coverage. Fact Sheet (.pdf)

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…