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.

Dual Eligibles

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  • Dual Eligible Home and Community-Based Waiver Program Participants and the New Medicare Drug Benefit

    Issue Brief

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  • National Survey of Physicians Part IV: Doctors, Payors, and Low-Income Patients

    Poll Finding

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  • New Reports Explore State Implementation of Prescription Drug Prior Authorization

    Other Post

    States are grappling with a fiscal crisis that threatens funding for Medicaid, the federal-state partnership that provides health coverage for low-income populations. Two new studies shed light on the impact of an increasingly popular strategy - prior authorization - being used to control prescription drug spending. In fiscal year 2003, some 21 states are planning to expand or create prior authorization systems where the state must provide pre-approval before selected drugs can be dispensed to…

  • State Responses to Budget Crisis in 2004: An Overview of Ten States – Overview and Case Studies

    Report

    In this report we examine how ten states from around the nation have responded to their budget crises in fiscal year 2004. While states vary in the depth of the budget pressures they faced, as state revenues remained depressed, all were required to make difficult choices among spending reductions, tax increases, or other revenue measures. In general, we found states with few exceptions relied on targeted revenue measures, such as cigarette and alcohol taxes, but…

  • Is the State Fiscal Crisis Over?  A 2004 State Budget Update – Report

    Issue Brief

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  • State Perspectives on Medicaid Long-term Care: Report from a July 2003 State Forum

    Report

    This report summarizes discussions on Medicaid and long-term care at a forum with state officials held by the Kaiser Commission on Medicaid and the Uninsured in July of 2003. The forum, conducted by the National Academy of State Health Policy, addressed issues including Medicaid's role in long-term care, state fiscal crises and cost-containment strategies, and how state long-term care programs are evolving. Report (.pdf)