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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  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion in the South

    News Release

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the…

  • Implications of the ACA Medicaid Expansion: A Look at the Data and Evidence

    Issue Brief

    More than four years after the implementation of the Medicaid expansion included in the Affordable Care Act, debate and controversy around the implications of the expansion continue. Despite a large body of research that shows that the Medicaid expansion results in gains in coverage, improvements in access and financial security, and economic benefits for states and providers, some argue that the Medicaid expansion has broadened the program beyond its original intent diverting spending from the…

  • Implications of a Medicaid Work Requirement: National Estimates of Potential Coverage Losses

    Issue Brief

    A number of states have received approval for, have applied for, or are considering Medicaid waiver proposals that would impose work requirements as a condition of eligibility, and some policymakers are calling for a federal requirement that all states implement work requirements in Medicaid. This analysis provides illustrative scenarios of potential nationwide reductions in Medicaid coverage if all states implemented work requirements similar to those currently proposed. The scenarios assume low and high disenrollment rates…

  • New Analysis Illustrates Potential Impact of Medicaid Work Requirements on Coverage if Implemented Nationally as Called for by House Budget Committee and Senate Legislation

    News Release

    As a number of states pursue Medicaid waivers to require certain beneficiaries to work in order to receive benefits, the House Budget Committee passed a budget resolution this month calling for the enactment of Medicaid work requirements in all states, a goal also advanced in proposed legislation in the Senate by Sen. John Kennedy of Louisiana. Although details are scant at this point, a new analysis from the Kaiser Family Foundation provides illustrative scenarios of…

  • Explaining Stewart v. Azar, the Federal District Court Decision Invalidating Kentucky’s Medicaid Waiver

    News Release

    A new issue brief from the Kaiser Family Foundation explains the June 29 federal court ruling invalidating the Kentucky HEALTH Medicaid waiver program and its implications for other states. The DC Federal District Court decision in Stewart v. Azar blocked Kentucky from implementing the waiver on July 1, including its work requirement, monthly premiums up to 4% of income, coverage lockouts for failure to timely renew eligibility or timely report a change in circumstances, and…

  • Federal Legislation Related to Medicaid and Opioids: What to Watch

    News Release

    With President Trump having declared the opioid epidemic a public health emergency, both the House and Senate are advancing legislation to address the crisis. A new issue brief from the Kaiser Family Foundation summarizes current federal legislative proposals related to Medicaid’s role in the opioid epidemic and identifies issues to watch as final legislation takes shape. The House has passed several bills culminating in the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment…

  • Voices from Puerto Rico: Reflections Two Months After Maria (Video)

    Video

    Residents of Puerto Rico discuss their daily lives and their views on recovery efforts two months after Hurricane Maria. In this video, they describe job loss and continuing economic disruption, a lack of basic services such as electricity and a rising toll on the population's mental and physical health.

  • Voices from Puerto Rico: Reflections Two Months After Maria (Report)

    Issue Brief

    Two months after Maria made landfall, Kaiser Family Foundation staff traveled to Puerto Rico. This brief presents findings from focus groups and individual interviews with 40 individuals from 10 different regions on the island affected by the storm.

  • Navigating Recovery: Health Care Financing and Delivery Systems in Puerto Rico and US Virgin Islands

    Issue Brief

    This brief identifies key issues and short and long-term options for recovery around the health care financing and delivery systems in Puerto Rico and the U.S. Virgin Islands following Hurricanes Irma and Maria, which caused significant physical damage to the territories. It draws on insights from a Nov. 30 roundtable discussion with leaders and experts representing a variety of perspectives on Medicaid policy, health insurance and care delivery systems, and disaster recovery.