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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  • Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

    Report

    This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation's Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and…

  • Explaining Armstrong v. Exceptional Child Center: The Supreme Court Considers Private Enforcement of the Medicaid Act

    Issue Brief

    On January 20, 2015, the United States Supreme Court will hear oral argument in Armstrong v. Exceptional Child Center, a case that raises the issue of whether Medicaid providers can challenge a state law in federal court on the basis that it violates the federal Medicaid Act and therefore is preempted by the Supremacy Clause of the U.S. Constitution. This issue brief examines the major questions raised by the Armstrong case, explains the parties’ legal…

  • A Comprehensive Review of Research Finds That the ACA Medicaid Expansion Has Reduced the Uninsured Rate and Increased Access to Care in Expansion States

    News Release

    Multiple studies find that the Affordable Care Act’s Medicaid expansion has increased coverage, with enrollment exceeding expectations in some states, while producing budget savings for states and reductions in uncompensated care costs for hospitals, according to a Kaiser Family Foundation review of 61 studies and policy reports. The literature review provides a useful reference on the effects of the ACA Medicaid expansion at a time when the future of the expansion – and the ACA more…

  • Overview of Medicaid Per Capita Cap Proposals

    Issue Brief

    The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per…

  • Two Year Trends in Medicaid and CHIP Enrollment Data: Findings from the CMS Performance Indicator Project

    Issue Brief

    This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight…

  • Medicaid’s Most Costly Outpatient Drugs

    Issue Brief

    Using Medicaid State Drug Utilization Data, this brief presents the 50 most costly drugs before rebates used by the Medicaid program over the January 2014 through June 2015 period. It then examines reasons why these drugs are so costly; explores case studies on opioids, hepatitis C drugs, and the drug Abilify; and considers policy implications.

  • Becoming Healthy Louisiana: System-Assisted Medicaid Enrollment

    Fact Sheet

    Enrollment in Louisiana’s Medicaid expansion, which began on June 1st, got off to a rapid start, with 233,794 new enrollees by June 30th. This robust beginning was due in large measure to months of behind-the-scenes work aimed at leveraging information from existing state systems to facilitate swift and seamless Medicaid enrollment. The state identified groups of people already participating in state-administered programs who are eligible for Medicaid under the new expansion, and quickly enrolled them…