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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  • Racial and Ethnic Disparities in COVID-19 Cases and Deaths in Nursing Homes

    Issue Brief

    This data note presents national data that shows that nursing homes with a high share of Black or Hispanic residents were more likely to have at least one coronavirus case, at least one COVID-19 death, and (among facilities with cases) more severe case outbreaks than facilities with a low share of Black or Hispanic residents. This piece also includes state-level data from 21 states where a sufficient sample of facilities with a high share of…

  • The COVID-19 Pandemic Has Taken a Higher Toll on Nursing Homes with Relatively High Shares of Black or Hispanic Residents

    News Release

    Nursing homes with a relatively high share of Black or Hispanic residents are more likely to have had a resident die of COVID-19 than homes with lower shares of such residents, finds a new KFF analysis. Nationwide, 63 percent of nursing homes with a relatively high share of Black residents reported one or more COVID-19 death, as did 55 percent of nursing homes with a relatively high share of Hispanic residents, finds the analysis. That…

  • Federal Medicaid Outlays During the COVID-19 Pandemic

    Issue Brief

    This data note analyzes federal Medicaid outlays before and during the COVID-19 pandemic. In the one year since the onset of the pandemic, federal Medicaid outlays totaled $500.8 billion and grew by 19.5%, compared to 6.3% growth in the one year before the pandemic.

  • Poll: Nearly Half of the Public Say They or a Family Member Skipped or Delayed Care Due to Coronavirus, But Most Plan to Get Care in the Coming Months

    News Release

    Nearly One in Four Expect a Family Member to Turn to Medicaid in the Coming Year, and Majorities across Party Lines Oppose Medicaid Cuts to Address State Budget Shortfalls Amid the threat of coronavirus, nearly half (48%) of Americans say someone in their family has skipped or delayed getting some type of medical care due to the pandemic, the latest KFF Health Tracking Poll finds. This includes 11% who say the person’s condition worsened due…

  • Limits and Opportunities of Federal Reporting on COVID-19 in Nursing Facilities

    Issue Brief

    In response to the widespread concerns about the high numbers of coronavirus cases and deaths in long-term care (LTC) facilities, CMS recently implemented new COVID-19 data reporting requirements for all federally certified nursing facilities. The newly-released federal data builds on state-reported data that has been included in many, but not all, states’ regular coronavirus reporting for several weeks. However, preliminary analysis indicates that the federal data will not reveal the full extent of the crisis…

  • JAMA Forum: Trump vs Biden on Health Care

    Perspective

    In this September 2020 post for The JAMA Health Forum, Larry Levitt highlights differences in the records and policy plans of President Donald Trump and former Vice President Joe Biden on key health care issues.

  • President Trump’s Record on Health Care

    Issue Brief

    This issue brief provides a detailed overview of the Trump Administration’s record on health care issues relating to: the Administration’s response to the COVID-19 pandemic, the ACA and private insurance markets, Medicaid, Medicare, reducing prescription drug and other health care costs, sexual and reproductive health, mental health and substance use, immigration and health, long-term care, HIV/AIDS policy, and LGBTQ health.

  • From the Federal Response to COVID-19 to Ongoing Efforts to Repeal the ACA and Proposals for Lowering Drug Prices, President Trump Has an Extensive Record on Health Care

    News Release

    Since taking office in 2017, President Trump has laid down an extensive record on health care, including his response to the COVID-19 pandemic, his early and ongoing efforts to repeal and replace the Affordable Care Act, his annual budget proposals to curb spending on Medicare and Medicaid, his executive orders and other proposals to lower prescription drug prices, and his initiative on hospital price transparency. President Trump’s record on health care provides a window into…