Medicaid

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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

Event Date:

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.

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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • Challenges of Providing Health Coverage for Children and Parents in a Recession: A 50 State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2009

    Report

    Overall, more than one-third of the states (19 states) took steps last year to increase access to health coverage for low-income children, pregnant women and parents –- including 15 states that authorized or implemented coverage expansions. At the same time, 10 states enacted at least one measure to restrict access. The report also examines trends in parental coverage and state outreach efforts, including the use of technology to facilitate enrollment. Full Report (.pdf) Data Tables…

  • CHIP TIPS: Medicaid Performance Bonus

    Issue Brief

    This brief, the first in a series, examines the new federal "performance bonus" available to states that do an especially good job of signing up eligible children for Medicaid. The bonus, created by a provision in the Children's Health Insurance Program Reauthorization Act of 2009, is designed to help states cover the added costs that result when states are very successful in enrolling eligible children in Medicaid above target levels specified in the law. It…

  • CHIP TIPS: Citizenship Documentation Changes

    Issue Brief

    This brief, the third in a series, examines changes to citizenship documentation requirements under the Children's Health Insurance Program Reauthorization Act of 2009. The law extends the requirement to document citizenship that applied in Medicaid to CHIP as well. At the same time, it modifies current requirements to reduce the paperwork burden on families and states and helps ensure that eligible children and others are enrolled and receive needed health care without delay. Brief (.pdf)

  • Key Issues in Medicaid and Home and Community-Based Services and Support

    Issue Brief

    These briefs examine current issues in providing more people who need long-term care services and supports access to these Medicaid services in home and community-based settings rather than in institutional ones. The first brief, Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts , highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates…

  • Efforts in States to Promote Medicaid Community-Based Services and Supports

    Issue Brief

    This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states. Brief (.pdf)

  • Children’s Health Coverage: Medicaid, CHIP, and Next Steps

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this briefing to examine the factors which influence children's coverage. Questions addressed include:What are the trends in private sector coverage? How well are the enrollment simplification and outreach tools that are included in this year’s CHIP reauthorization helping to reach those children who are eligible but unenrolled? How much does a child’s coverage depend on where he or she lives? For more information,…

  • Expanding Medicaid to Low-Income Childless Adults Under Health Reform: Key Lessons From State Experiences

    Issue Brief

    The health reform law will expand Medicaid to millions of low-income adults, including many childless adults who have historically been ineligible for the program, necessitating one of the largest enrollment efforts in the program's history. This report, based on interviews with officials in seven states and the District of Columbia and national experts, examines lessons learned from past state experience covering childless adults through waiver and state-funded programs and profiles the programs included in the…

  • More Than Meets the Eye: Long-Term Care Provisions in the New Reform Law

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    Event

    In the debates around the health reform law and its implementation, little attention has been given to the law's provisions supporting long-term care. This briefing offered an overview of these provisions, such as the CLASS Act, a new national, voluntary insurance program to help working adults finance services and supports that they may need in the future, and the Community First Choice Option, which helps Medicaid recipients get attendant care at home. This October 1…

  • An Overview of Changes in the Federal Medical Assistance Percentages (FMAPs) for Medicaid

    Issue Brief

    The joint federal-state financing of the Medicaid program works through a matching mechanism known as the Federal Medical Assistance Percentage (FMAP). This mechanism determines the federal and state shares of Medicaid costs based on a state's per capita personal income relative to the national average. While the FMAP formula has remained unchanged since the enactment of the Medicaid program in 1965, changes in per capita income have resulted in substantial changes in the federal and…

  • Managing Costs and Improving Care: Team-based Care of the Chronically Ill

    Event Date:
    Event

    Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs. This briefing, cosponsored by the Alliance for Health Reform and The Commonwealth Fund, looked at ways to improve the quality of care for the chronically ill while reducing the growth in spending for their care.…