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 Eligibles: Medicaid’s Role in Filling Medicare’s Gaps

    Issue Brief

    Dual Eligibles: Medicaid's Role in Filling Medicare's Gaps - Issue Brief This paper presents a profile of dual eligible beneficiaries (those qualifying for both Medicare and Medicaid), describes their health care expenditures, and analyzes the distribution of spending on the population. Issue Paper (.pdf)

  • 2002 State and National Medicaid Spending Data

    Report

    (CMS-64) This set of tables, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state-by-state information on Medicaid spending by services using data from the Centers on Medicaid and Medicare Services (CMS) Form 64 for Federal Fiscal Year (FFY) 2002. CMS-64 data provide a somewhat different measure of spending than does the Medicaid Statistical Information System (MSIS). Please refer to the "Overview of Differences" document below…

  • 2000 State and National Medicaid Enrollment and Spending Data (MSIS)

    Report

    This set of tables, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, presents state-by-state information on Medicaid enrollment, expenditures, and spending per enrollee for Federal Fiscal Year (FFY) 2000. These tables are based on analysis of data from the Medicaid Statistical Information System (MSIS) and provide a somewhat different measure of spending than CMS-64 data. Please see the "Overview of Differences" document below for more on the features of…

  • Health Coverage and Access Challenges for Low-Income Women

    Issue Brief

    This issue brief examines low-income women’s health insurance coverage, experience with health plans and providers, and access to care. The analysis is based on data from the 2001 Kaiser Women’s Health Survey, a nationally representative survey of nearly 4,000 women between the ages of 18 and 64. Issue Brief (.pdf)

  • Medicaid’s Federal-State Partnership: Alternatives for Improving Financial Integrity – Summary of Issues, Approaches, and Alternatives for Reform

    Report

    In this report from the Kaiser Commission on Medicaid and the Uninsured, Penny Thompson, former deputy director for the Center for Medicaid and State Operations, used existing models from the private sector and other government programs to assess Medicaid’s financial management and to develop options for improvement. This table summarizes the report’s findings. Chart (.pdf) Report

  • Medicaid Financing and Fiscal Management:  A Discussion of the Current Federal-State Partnership and Program Integrity

    Other Post

    Medicaid Financing and Fiscal Management: A Discussion of the Current Federal-State Partnership and Program Integrity The Kaiser Commission on Medicaid and the Uninsured will host a discussion for reporters on Tuesday, March 2, 2004 to discuss Medicaid financing and fiscal management and related proposals for change. Reporters in the area are invited to participate from our office; all reporters are invited to participate via conference call. For more information, call 202-654-1313. Medicaid's Federal-State Partnership: Alternatives…

  • Medicaid’s Federal-State Partnership: Alternatives for Improving Financial Integrity

    Report

    - Report As the federal government increases its scrutiny of state financing of the Medicaid program, this paper, authored by a former CMS official, evaluates the existing financial management of the Medicaid program. Using existing models from the private sector and the government, the paper identifies alternatives to improve Medicaid's financial management without changing Medicaid's existing financing structure. The alternatives would reduce the Medicaid program's exposure to questionable practices, help control federal costs, and make…

  • Medicaid and Block Grant Financing Compared

    Issue Brief

      - Issue Brief State and federal budget pressures, rising health care costs, and new waiver initiatives have promoted debate over restructuring Medicaid at the federal and state level. Questions about how Medicaid is financed are central to this debate. This paper compares the current Medicaid financing system to a generic block grant financing system to illustrate the key differences in the structure and incentives of these alternative approaches. Issue Brief (.pdf)  

  • 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)

  • SCHIP-Enrolled Children with Special Health Care Needs

    Report

    : An Assessment of Coordination Efforts Between State SCHIP and Title V Programs This study explores how the State Children’s Health Insurance Program serves children with special needs and assesses the role of the Title V Maternal and Child Health Services Block Grant program in filling in gaps in coverage. It also discusses the implications of state choices on publicly-funded health coverage for pediatric health care. Report (.pdf)