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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.

Dual Eligibles

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  • Medicaid Matters: Hearing from Families

    Other Post

    A Video The Kaiser Commission on Medicaid and the Uninsured's video profiles five families who have children covered by Medicaid. These five families reflect the diversity of those helped by Medicaid -- families from all over the country of varying races/ethnicities, ages and sizes. Each family also illustrates a particular health care need and shows how Medicaid assists in obtaining needed health care services. Also available in Low Speed. (8 min.) Brochure To order a…

  • States’ Concerns About the Medicare Drug Debate and the Fiscal Impact of Shifting the Cost of Dual Eligible Care

    Issue Brief

    As the U.S. Congress continues to search for an agreement on the form of a Medicare prescription drug benefit, the Commission has two new reports related to the debate. One new publication reports on findings from an October 26 discussion with state Medicaid officials on the implications of a Medicare drug benefit for states and dual eligibles. The other report provides state-level estimates on spending on dual eligibles and illustrates the effects of scenarios where…

  • Serving Low-Income Families Through Premium Assistance: A Look At Recent State Activity

    Issue Brief

    This issue paper examines the policies in the HIFA waiver initiative that provide incentives for states to use Medicaid/SCHIP funds to assist in the purchase of private insurance options. It also reports on how states have responded to these new policies and what key policy questions are raised about premium assistance programs. Issue Paper (.pdf)

  • Medicaid: Issues and Challenges

    Event

    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured, testified to the U.S. House Energy and Commerce Committee's Subcommittee on Health on the issues and challenges facing Medicaid in providing health and long-term care coverage for the low-income population. Testimony (.pdf)

  • Health Challenges Facing the Nation

    Event

    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured, testified to the Joint Economic Committee of the U.S. Congress on health insurance coverage and how the uninsured population remains one of the nation's most pressing health care challenges. Testimony (.pdf)