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Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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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  • New Publications Examine SCHIP Experience; Trends in Access to Medicaid and SCHIP Coverage

    Fact Sheet

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children's Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

  • State Children’s Health Insurance Program at a Glance

    Fact Sheet

    A fact sheet that provides an overview of how the State Children's Health Insurance Program is administered and financed, who is eligible, what services are covered, and what the policy issues are for the program's reauthorization. Fact Sheet (.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)

  • Beyond Cash and Counseling: The Second Generation of Individual Budget-Based Community Long-Term Care Programs for the Elderly

    Report

    States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. Beginning in January 2007, a new provision in the Deficit Reduction Act of 2005 (DRA) allows states to offer an individual budget option for an expanded range of home- and community-based services in their Medicaid state plans…

  • Aging Out of Early and Periodic Screening, Diagnostic and Treatment (EPSDT): Issues for Young Adults with Disabilities

    Issue Brief

    Early and Periodic Screening, Diagnostic and Treatment (EPSDT) coverage offered through the Medicaid program has played an important and unique role for low-income children with disabilities, and maintaining this support is a key concern. This issue brief discusses the challenges and implications for young people with disabilities when they become adults and lose their EPSDT benefits and how recent changes to the Deficit Reduction Act give states an opportunity to increase the availability of services…

  • A Decade of SCHIP: Experience and Issues for Reauthorization

    Issue Brief

    A Decade of SCHIP: Experience and Issues for Reauthorization As the SCHIP program is due for reauthorization in 2007, this brief explores some lessons learned and highlights key policy issues for the upcoming debate. Issue Brief (.pdf)

  • Resuming the Path to Health Coverage for Children and Parents: A 50-State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2006

    Poll Finding

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children’s Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

  • Medicaid and Long-Term Care: Recent Publications Illuminate Key Policy Issues

    Fact Sheet

    With recent policy debates about the future of Medicaid, the Foundation's Kaiser Commission on Medicaid and the Uninsured has created a resource page of recent publications that address key policy issues when examining Medicaid's role for high cost populations and in long-term care. Of particular interest are a report profiling six Medicaid populations with serious health needs resulting in high costs for the program and a recent analysis showing more than half (52%) of Medicaid…

  • SCHIP Enrollment in 50 States: June 2005 Data Update

    Report

    This report finds that monthly SCHIP enrollment reached a record high of more than 4 million in June 2005, reversing the decline seen in the previous 12 month period. SCHIP enrollment rose in all but nine states, including large increase in California, Georgia, and Illinois. Report (.pdf)