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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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  • Medicaid: Purchasing Prescription Drugs

    Issue Brief

    Medicaid: Purchasing Prescription Drugs A policy brief explaining how Medicaid purchases outpatient drugs and outlining the policy tools available to states to limit the rate of growth in spending on prescription drugs. Policy Brief (28 pages)

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    Issue Brief

    This policy brief examines health coverage for low-income parents after the 1996 welfare law broke the historical connection between Medicaid coverage and welfare. Many states have altered their rules and some have expanded coverage for low-income working parents. Policy Brief

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    Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…

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    This report analyzes data from a survey of 42 low-income families with children with moderate or severe disabilities to better understand the impact of welfare reform on health coverage for these families. Report

  • The Financing of Pharmacy Plus Waivers: Implications for Seniors on Medicaid of Global Funding Caps

    Issue Brief

    This policy brief describes Pharmacy Plus waivers being considered by some states for their Medicaid program and their implications for Medicaid financing. These waivers offer an opportunity for prescription drug coverage for low-income seniors, but they also include a major change in the financing of care for all seniors on Medicaid -- a cap on federal Medicaid funding for all services provided to seniors on Medicaid. Policy Brief

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    Report

    This report presents information on the number of children enrolled in SCHIP for each state, for specific months from 1998 to December 2002. As of December 2002, the SCHIP program covered 3.7 million low-income children. An increase of 280,000 children during 2002. Report

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    Issue Brief

    This report presents the results of eight focus groups conducted in several languages throughout California to explore the knowledge and opinions of parents of potentially eligible children about the Medi-Cal program, California's Medicaid program. The study found that participants were confused about eligibility requirements, found the enrollment process onerous and demeaning, and had suggestions about how they could be better educated about the program. Policy Brief: Medi-Cal Eligibility And Enrollment (.pdf)   Report: Barriers to…