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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.

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  • Building an On-Ramp to Children’s Health Coverage:  A Report on California’s Express Lane Eligibility Program

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    Building an On-Ramp to Children's Health Coverage: A Report on California's Express Lane Eligibility Program This report documents the results from California’s Express Lane Eligibility (ELE) initiative through the school lunch program (now one year into implementation), which has been piloted in 72 schools in 5 school districts in the state. ELE is an enrollment strategy that targets large numbers of uninsured children, who are eligible for the federal-state programs Medicaid and SCHIP, where they…

  • States’ Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion

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    States' Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion The Medicare Modernization Act (MMA) created a major new subsidy program for an estimated 14 million low-income Medicare beneficiaries that will provide assistance with their cost-sharing obligations under the Part D drug benefit. The MMA requires state Medicaid agencies, along with the Social Security Administration (SSA), to accept applications for the new low-income subsidy. MMA also specifies that people who…

  • Health Care and the 2004 Elections

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    ** Update: For information on health care and the 2008 election, visit www.health08.org. ** Health care issues continue to be important for many Americans and a vital part of the policy debates in Washington and around the country. During an election season, candidates propose and debate their solutions for the pressing policy issues facing their constituents. The 2004 election season is no different and the Kaiser Family Foundation is issuing informational materials on some of…

  • Medicaid and Other Public Programs for Low-Income Childless Adults:  An Overview of Coverage in Eight States

    Report

    Medicaid and Other Public Programs for Low-Income Childless Adults: An Overview of Coverage in Eight States This report profiles childless adult programs in eight state-level jurisdictions: the District of Columbia, Maine, Massachusetts, Minnesota, New York, Oregon, Pennsylvania, and Washington. Report (.pdf) Background State Reports prepared by the Economic and Social Research Institute

  • Tennessee’s New “Medically Necessary” Standard:  Uncovering the Insured?

    Issue Brief

    Tennessee's New "Medically Necessary" Standard: Uncovering the Insured? This policy brief describes a new standard passed by Tennessee’s legislature for determining whether an item or service is “medically necessary” under the state’s Medicaid program, TennCare. The brief concludes with some questions regarding the implications of the new standard for the populations that Medicaid covers nationally, especially low-income children under age 21, individuals with disabilities, and the elderly, as well as the providers who treat them.…

  • Roundtable Discussion of Medicaid Waivers: Lessons for California

    Other Post

    Medicaid Waivers: Lessons from California, a roundtable discussion hosted by the Foundation and the University of California, Berkeley Center for Health and Public Policy Studies on Wednesday, July 28, 2004, provided an overview of current Section 1115 waiver activity across the states, focusing on Health Insurance Flexibility and Accountability (HIFA) Initiative waiver efforts. Findings from recent studies of waiver programs in other states such as Oregon, Utah, and New Hampshire were presented and discussed. Panelists…