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5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

Tracking Medicaid Work Requirements:
Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage

  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.

  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.

  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Implications of Reduced Federal Medicaid Funds: How Could States Fill the Funding Gap?

    Issue Brief

    In this analysis, we present three scenarios of reductions in federal Medicaid spending and examine fiscal implications if states fill these financing gaps to maintain their programs and if all reductions are assumed to be in full effect in FFY 2015 (the most recent year for which Medicaid spending data is available). To fill these gaps in financing and maintain current Medicaid programs, we assume states will increase state spending for Medicaid by increasing state taxes or reducing education spending. This analysis is unlike the CBO estimate, which makes projections and accounts for changes in policy, state responses to make changes to Medicaid programs, and reductions in coverage.

  • Data Note: Three Findings about Access to Care and Health Outcomes in Medicaid

    Issue Brief

    The Medicaid program covers 74 million low-income Americans, including many of the poorest and sickest people in our society. Among those served are pregnant women and children, parents and other adults, poor seniors, and people with disabilities. Given Medicaid’s major coverage role and the complex needs of the populations it covers, data and evidence on access to care and health outcomes in Medicaid are of key interest. Such an assessment is also important to ensure that debate about the effectiveness of the Medicaid program is grounded in facts and analysis. This Data Note discusses what the research shows.

  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.

  • Key Questions About Medicaid Block Grants

    News Release

    As policymakers in Washington discuss Affordable Care Act repeal and a possible block grant for Medicaid, a new issue brief from the Kaiser Family Foundation lays out key questions to consider in restructuring federal financing of the nation’s health insurance program for low-income Americans.

  • Data Note: Medicaid Managed Care Growth and Implications of the Medicaid Expansion

    Issue Brief

    Most states today rely heavily on risk-based managed care organizations (MCOs) to serve Medicaid beneficiaries. This Data Note discusses the current role of managed care in Medicaid and examines differences in managed care growth between states that expanded Medicaid to low-income adults under the Affordable Care Act (ACA) and states that did not expand Medicaid.

  • Medicaid Managed Care and the Provision of Family Planning Services

    Report

    Three quarters of reproductive age women on Medicaid are enrolled in managed care arrangements. This analysis explores the experiences and perspectives of leaders of Medicaid Managed Care Organizations (MCOs) in structuring their networks and services to provide family planning and reproductive health services to women. It finds that MCOs rely heavily on safety net clinics including Community Health Centers and Family Planning Clinics such as Planned Parenthood to provide in-network family planning services to their members. MCO leaders also identified churning in enrollment, the high costs of stocking IUDs and implants, global hospital payment methodologies for maternity care, and the inclusion of faith-based providers in plan networks as potential barriers to certain family planning services.