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Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies.

Medicaid Budget Survey

Medicaid Home Care

Using data from the 23rd KFF survey of officials administering Medicaid home care programs, this issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect. The data come from KFF’s 23rd survey on Medicaid home care programs in all 50 states and DC.

KFF regularly surveys states about their Medicaid home- and community-based services (HCBS) programs and their eligibility policies for people who are eligible for Medicaid on the basis of having a disability or being 65 and older.

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This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.

Eligibility and coverage

  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.

  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.

  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

The Essentials

  • 5 Facts: Immigrants and Medicaid

    This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.

  • 5 Facts: Medicaid and Hospitals

    This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.

  • Medicaid Financing: The Basics

    Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.

  • 5 Facts: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 5 Facts: Medicaid and Nursing Facilities

    The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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  • 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 (.

  • Health Coverage for Low-Income Parents

    Fact Sheet

    The fact sheet summarizes the health coverage of low-income parents, including recent trends, and discusses the current policy challenges related to expanding care for this population. Fact Sheet (.

  • Health Insurance Coverage and Access to Care for Low-Income Non-Citizen Children

    Issue Brief

    Largely due to a high uninsured rate, low-income, non-citizen children have very poor access to care, with many lacking a regular provider and going without preventive care. This brief examines health coverage and access to care for low-income, non-citizen children to provide insight into the challenges they face in obtaining health insurance and accessing care.

  • Medicaid’s Role for People With Disabilities

    Event

    Diane Rowland testified before the House Energy and Commerce Subcommittee on Health about Medicaid’s development as a vital source of coverage for people with disabilities and its current role providing coverage and access to health services and supports for this population. Testimony (.

  • New Reports and Briefing Focus on Dental Health Coverage and Access

    Fact Sheet

    More than 100 million Americans have no insurance to help cover dental needs. With health reform discussions ongoing, the Foundation's Kaiser Commission on Medicaid and the Uninsured (KCMU) cosponsored a briefing which examined oral health in the broader conversation of improving quality and expanding access. Three new reports from KCMU were released at the event.

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system.

  • Medicaid’s Role for Dual-Eligible Beneficiaries

    Issue Brief

    This brief examines the role of Medicaid in providing health coverage to the 9.6 million Medicare beneficiaries who are also eligible for Medicaid. The brief explains the role Medicaid plays in providing supplemental coverage to fill in the gaps in Medicare’s coverage for these dual-eligible beneficiaries.