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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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  • Keeping Medicare and Medicaid When You Work, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide helps to explain the program rules for Medicare and Medicaid with regard to work. Medicare and Medicaid have come to play important roles in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and this guide gives people with disabilities new information to help them get the most from these programs. Full PDF Report Section 1: Protecting Health Coverage For People With Disabilities Who Work HTML…

  • Financing Health Coverage:  The State Children’s Health Insurance Program Experience

    Issue Brief

      Financing Health Coverage: The State Children's Health Insurance Program Experience Enactment of SCHIP sought a balance between increasing funds available for coverage and limiting total federal outlays. While SCHIP has had widespread support and success in helping to provide coverage for uninsured children, its capped financing system has also created challenges for states, including inequities among states and projected federal funding shortfalls. This issue brief explores three basic sets of issues associated with SCHIP’s…

  • Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005

  • Transitions 2005

    Video

    Transitions is a video that explores some of the issues and challenges “dual eligibles” may face during the transition from Medicaid drug coverage to Medicare.

  • What Has Caused the Growth in Medicaid Spending in Recent Years?

    Event Date:
    Event

    A new study published in Health Affairs explains what caused Medicaid spending to rise from 2000-2003 and confirms the role Medicaid played in covering people during the recent economic downturn, and that Medicaid per enrollee spending grew at a slower rate than private insurance spending. The Kaiser Commission on Medicaid and the Uninsured and Health Affairs cosponsored a briefing to discuss the findings of the study. News Release Understanding the Recent Growth in Medicaid Spending,…

  • The Implications of the Medicare Prescription Drug Benefit for Dual Eligibles

    Other Post

    Three new reports focus on one of the biggest challenges in the implementation of the Medicare Modernization Act, the transitioning of drug coverage for individuals dually eligible for Medicaid and Medicare, who now get their drug coverage from Medicaid, to the new Medicare benefit. The New Medicare Prescription Drug Law: Issues for Enrolling Dual Eligibles into Drug Plans Medicare's New Prescription Drug Benefit: The Voices of People Dually Covered by Medicare and Medicaid Implications of…

  • Medicaid Section 1115 Waivers: Current Issues

    Fact Sheet

    This fact sheet provides a brief introduction to Section 1115 waivers in the Medicaid program and highlights policy issues related to recent waiver activity. Fact Sheet (.pdf)