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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.

2025-2026 Medicaid Budget Survey

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

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.

Waiting Lists for Medicaid Home Care, 2016 to 2025
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.

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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  • Medicaid 1915(c) Home and Community-Based Service Programs: Data Update

    Issue Brief

    Over the last four years, the Commission has been tracking the national development of the three main Medicaid HCBS programs that states can operate. The Commission also began to survey the policies, such as eligibility criteria and waiting lists that states can use to control the growth of spending on the waiver programs.

  • Ten Myths About Medicaid

    Issue Brief

    This issue brief outlines ten key myths and related facts about Medicaid.

  • Medicaid at 40

    Video

    The Kaiser Family Foundation has produced three documentaries to mark the 40th anniversary of Medicare and Medicaid. The documentaries examine the social needs that led policymakers to create these programs, the expectations of what they would achieve and the reality of these programs today. Key policymakers, staff officials and members of Congress involved in the creation and implementation of Medicare and Medicaid are interviewed. Extensive use of historic video helps tell the story of these landmark social programs.

  • Medicare and Medicaid at 40

    Video

    The Medicare and Medicaid health coverage programs were signed into law July 30, 1965. The Kaiser Family Foundation has some new resources that examine how Medicare and Medicaid came into existence and how they have evolved over the past 40 years. You will find new documentaries and extended interviews with key policymakers and government officials examining the origins of Medicare and Medicaid, new interactive historical timelines, a chart pack of key information and statistics, a webcast of a retrospective of the two programs with historian Robert Dallek and key government officials responsible for the programs over the past 40 years, and many other background resources on the two programs.

  • Women and Health Care: A National Profile

    Report

    A new national survey of women on their health finds that a substantial percentage of women cannot afford to go to the doctor or get prescriptions filled. Although a majority of women are in good health and satisfied with their health care, many have health problems and do not get adequate levels of preventive care.

  • Women and Health Care: A National Profile – Report

    Report

    Report - Women and Health Care: A National Profile Women and Health Care: A National Profile is a nationally representative telephone survey of 2,766 women ages 18 and older. A shorter companion survey of 507 men was also conducted. Full Report (.pdf) Report Highlights (.pdf) Introduction and Methods (.

  • The California Medicaid Program at a Glance

    Fact Sheet

    This fact sheet provides an overview of California's Medicaid program, Medi-Cal, the population that it serves, and the services it covers. Fact Sheet (.

  • The Distribution of Assets in the Elderly Population Living in the Community

    Issue Brief

    Individuals cannot qualify for Medicaid nursing home care or home and community-based services unless they meet their state's asset eligibility standards. Currently, states are required to examine all transfers for less than fair market value that occurred within 36 months prior to an individual's application for Medicaid.