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

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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.

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.

Dual Eligibles

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  • Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Report

    This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and fraud and abuse. Report (.pdf)

  • The New Medicare Prescription Drug Law:  Issues for Dual Eligibles with Disabilities and Serious Conditions

    Issue Brief

    The New Medicare Prescription Drug Law: Issues for Dual Eligibles with Disabilities and Serious Conditions The new issue paper discusses the challenges the new Medicare drug program faces in meeting the needs of dual eligible individuals with disabilities, who tend to have extensive, complex and varying needs. The brief examines four key questions about how the new benefit will serve dual eligibles with disabilities and profiles some individuals from this population for whom prescription drugs…

  • The New Medicare Rx Benefit:  Challenges for Maintaining Access to Prescription Drugs

    Other Post

    The New Medicare Rx Benefit: Challenges for Maintaining Access to Prescription Drugs With the launch of the new Medicare Part D prescription drug benefit less than 18 months away, and growing interest in beneficiaries’ access to medications in the future, the Kaiser Family Foundation is pleased to release two new publications that examine issues concerning access to medications raised by the implementation of the new Part D Medicare prescription drug benefit. The New Medicare Drug…

  • Economic Stress and the Safety Net: A Health Center Update

    Issue Brief

    The issue paper provides data on the demographic profile of health center patients and the revenue sources available for financing their care, including recent increases in federal discretionary funding. It examines the impact of the recent economic downturn on health centers in selected communities, exploring the effect of elevated unemployment levels among lower wage workers, declining private health insurance coverage, and widespread cutbacks in Medicaid--the single most important source of health center financing. Issue Paper…

  • The President’s FY 2005 Budget Proposal:  Overview and Briefing Charts

    Report

    The President's FY 2005 Budget Proposal: Overview and Briefing Charts The overview and briefing charts present information on the President's FY 2005 budget proposal to Congress beginning with federal surplus/deficit spending historical data and a summary of the overall composition of the Administration's budget request. The charts then detail information on the President's funding proposals for major health programs. Overview & Briefing Charts (.pdf)

  • Issues Surrounding the “Clawback” or State Contributions Towards Medicare Drug Coverage:  A Conference Call Discussion

    Other Post

    Issues Surrounding the “Clawback” or State Contributions Towards Medicare Drug Coverage: A Conference Call Discussion As part of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 signed into law last year, Congress included a financing provision that requires a monthly payment from each state to the Medicare program beginning in January 2006. MMA’s clawback provision will recapture most of the savings that states would realize when Medicare assumes prescription drug costs for…

  • The “Clawback:” State Financing of Medicare Drug Coverage

    Issue Brief

    This issue paper describes the origins of the clawback, the formula by which each state’s clawback amount is calculated, and the clawback’s implications for states and for low-income Medicare beneficiaries. Issue Paper (.pdf)

  • Medicaid Prescription Drug Spending and Use

    Issue Brief

    This issue paper provides the latest data and trend analysis on Medicaid prescription drug spending and utilization. In 2002, Medicaid programs spent $30 billion for prescribed drugs. Issue Paper (.pdf)