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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.

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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  • Vermont’s Global Commitment Waiver: Implications for the Medicaid Program

    Issue Brief

    This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program. In the fall of 2005, Vermont secured approval for a Section 1115 Medicaid waiver known as the "Global Commitment waiver" that allows the state to fundamentally restructure its Medicaid program. The…

  • Outreach Strategies for Medicaid and SCHIP: An Overview of Effective Strategies and Activities

    Report

    Outreach Strategies for Medicaid and SCHIP: An Overview of Effective Strategies and Activities This paper highlights key components of effective outreach strategies to enroll children in Medicaid and SCHIP and also to get them access to care once enrolled. In addition, the paper examines how these strategies have been implemented in states and the challenges of continuing to push for enrollment as states face continued fiscal pressures and barriers to participation are resurrected. Report (.pdf)

  • Opening Doorways to Health Care for Children: 10 Steps to Ensure Eligible but Uninsured Children Get Health Insurance

    Report

    Despite the success of Medicaid and SCHIP in reducing the number of uninsured low-income children by one-third in the last decade, over eight million children remain uninsured. Seventy percent of these uninsured children are eligible for public health coverage. This report by the Children's Partnership lays out a plan for creating a series of enrollment doorways that make enrollment and renewal of children both routine and timely -- as close to automatic as possible. The…

  • Who Needs Medicaid?

    Issue Brief

    This brief reviews Medicaid’s current eligibility structure and the health needs of the people covered by Medicaid. Due to the trends of limited and declining access to private health coverage in the low-income population and the growing health and long-term care demands of an aging population, a broader model for Medicaid eligibility is considered and the implications of recent legislative and policy developments for coverage are assessed. Issue Brief (.pdf)

  • Medicaid and SCHIP Eligibility for Immigrants

    Fact Sheet

    Immigrants in the U.S. face increasing challenges securing health care coverage. They have less access to employer-sponsored insurance than native citizens and face tighter restrictions on their eligibility for Medicaid and SCHIP, the nation’s major public health coverage programs for low-income children and families. This fact sheet provides an overview of the current rules on immigrants' eligibility for Medicaid and the State Children's Health Insurance Program. Fact Sheet (.pdf)

  • Reports Explore Long-Term Care Issues Included in the Deficit Reduction Act

    Issue Brief

    The Deficit Reduction Act (DRA) of 2005, which became law this February, includes several significant changes to Medicaid long-term care policies. The Kaiser Family Foundation's Commission on Medicaid and the Uninsured is releasing five new reports on long-term care issues that were addressed by the DRA changes. Long-term care accounts for 36 percent of Medicaid spending (over $100 billion annually) and is utilized by many of Medicaid's most costly beneficiaries, the low-income elderly and individuals…

  • Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs

    Issue Brief

    Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver. Issue…

  • Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance

    Issue Brief

    Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act (DRA) of 2005 tightened Medicaid eligibility rules related to asset transfers. About 43 percent of all nursing home residents eventually become Medicaid eligible. This brief concludes that for people becoming Medicaid eligible at the time of nursing home admission, 50 percent had…

  • 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)

  • Nursing Home Transition Programs: Perspectives of State Medicaid Officials

    Report

    Nursing Home Transition Programs: Perspectives of State Medicaid Officials This report draws on interviews with state Medicaid program officials 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)