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.

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  • The Shifting Sands for State Medicaid Programs Lurking in Our Data

    From Drew Altman

    KFF President and CEO Drew Altman examines the coming squeeze on state budgets and state Medicaid programs, stemming from declining federal matching funds, weakening state revenues, and competing state priorities, and the challenges it poses for states seeking to strengthen their programs and try innovative new approaches.

  • More Children are Losing Medicaid Coverage as Child Poverty Grows 

    News Release

    Children’s Medicaid and Children’s Health Insurance Program (CHIP) enrollment declined by 5.5%, or 2.3 million children, from March 2023, before the unwinding began, to September 2023, according to KFF’s latest analysis. Across all 50 states and DC, at least 14,377,000 people were disenrolled from Medicaid between April 1 and January 9, 2024. Medicaid eligibility levels are higher for children, raising concerns that they may be losing coverage and becoming uninsured despite remaining eligible. Medicaid covers…

  • Halfway Through the Medicaid Unwinding: What Do the Data Show?

    Policy Watch

    Ten months into the unwinding of the Medicaid continuous enrollment provision, KFF tracking shows that states have reported outcomes for roughly half of the people expected to undergo renewals during the unwinding period. This policy watch examines the latest data and key issues to watch during the next phase of the unwinding.

  • Few Nursing Facility Residents and Staff Have Received the Latest COVID-19 Vaccine

    Issue Brief

    KFF analysis found that over one-fifth of all U.S. COVID-19 deaths occurred in long-term care facilities despite but as of January 14th, 2024, only 38% of residents and 15% of staff were “up-to-date” with their COVID-19 vaccines, which the CDC defines as having received the updated Fall 2023 vaccine. Those rates are lower than uptake was for the 2022 vaccine.

  • Few Nursing Facility Residents and Staff Have Gotten the Latest COVID-19 Vaccines

    News Release

    Fewer nursing facility residents and staff are getting COVID-19 vaccines, according to a new KFF analysis of federal data. Only 38% of residents and 15% of staff have received the latest vaccine. In comparison, 50% of residents and 22% of staff received updated vaccines in 2022 and 87% of residents and 88% of staff completed the initial vaccination series. The percentage of residents who received the latest COVID-19 vaccine varies by state and type of…

  • KFF Examines Challenges in Navigating Coverage for Opill, the First Over-the-Counter Daily Oral Contraceptive Pill, Coming to Market Next Year 

    News Release

    As Opill—the first over-the-counter daily oral contraceptive pill in the United States—is expected to be available for purchase in early 2024, new research conducted by KFF examines barriers to its accessibility for consumers and challenges in providing insurance coverage for it. Based on interviews with nearly 80 representatives from private insurance plans, state Medicaid programs, chain pharmacies, and other key groups, the report provides a deeper view into the operational challenges in expanding access to…

  • End of Pandemic-Era Policies in Medicaid Home- and Community-Based Services Could Challenge Family Caregivers and Enrollees

    News Release

    Family caregivers played a key role in supporting people who used Medicaid home- and community-based services (HCBS) during the COVID pandemic. Many states used new pandemic-era authorities to support and pay family caregivers and maintain services in other ways amid workforce shortages and other challenges. Now, several states are ending payments to family caregivers and unwinding other pandemic-era policies, which could complicate ongoing workforce shortages and create new challenges for enrollees, according to survey of…