Medicaid

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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

Event Date:

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.

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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  • Red-State Changes Could Strengthen ACA, Medicaid

    From Drew Altman

    In an Axios column, Drew Altman discusses how, ironically, efforts by red states to move their ACA marketplaces and their Medicaid programs in  more conservative directions could end up strengthening the ACA and Medicaid politically over the longer term.

  • Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Event)

    Event Date:
    Event

    Six months after Hurricanes Irma and Maria battered Puerto Rico and the U.S. Virgin Islands, the U.S. territories continue to struggle with crippled infrastructure, faltering economies and an exodus of their populations to the continental U.S.  On Monday, March 19, 2018, the Kaiser Family Foundation held a public briefing to examine the status of the recovery on the islands, with a focus on how their health care systems are doing and the likely impact of…

  • How Might Older Nonelderly Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waivers?

    Issue Brief

    Most of the states with approved or pending Section 1115 waivers that condition Medicaid eligibility on work would apply those requirements to all or most nonelderly adults (ages 19-64) who are not receiving Supplemental Security Income (SSI) cash assistance, including older nonelderly adults (ages 50-64). Older nonelderly adults may be limited in their ability to satisfy a work requirement due to barriers resulting from age and/or disability. Previous analysis shows that many nonelderly Medicaid adults…

  • Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016

    Report

    This report provides information on recent trends in nursing facilities in the United States, drawing on data from the federal On-line Survey, Certification, and Reporting system (OSCAR) and more recent Certification and Survey Provider Enhanced Reports (CASPER). We use these databases to provide information on nursing facility characteristics, resident characteristics, facility staffing, and deficiencies by state from 2009 through 2015. This data enables policymakers and the public to monitor and understand recent changes in nursing…

  • Kaiser Health Tracking Poll – May 2017: The AHCA’s Proposed Changes to Health Care

    Report

    With House Republicans passing the American Health Care Act (AHCA), their plan to repeal and replace the Affordable Care Act (ACA), and the Senate currently debating the plan and discussing their own approach, the latest tracking poll finds more view the ACA favorably than view the AHCA favorably. The poll examines attitudes towards specific provisions included in the replacement plan and how the public thinks the replacement plan will affect their own health care.

  • How do Premiums and Cost Sharing Affect Low-Income People in Medicaid?

    News Release

    A new issue brief from the Kaiser Family Foundation reviews what the research shows about the effects of premiums and cost sharing on low-income populations in Medicaid and the Children’s Health Insurance Program (CHIP), drawing upon 65 peer-reviewed studies and government and research and policy organization reports and studies published between 2000 and March 2017. The review comes at a time when some state and federal policymakers have proposed allowing state Medicaid programs to charge…

  • Next Steps for CHIP: What is at Stake for Children?

    Fact Sheet

    The Children’s Health Insurance Program (CHIP) is an important complement to Medicaid, covering 8.4 million children with family incomes above Medicaid eligibility limits who often lack access to affordable private coverage. Following are key facts that highlight what is at stake for children if there is a failure to extend CHIP funding beyond September 2017 and based on changes proposed in the American Health Care Act (AHCA), which would fundamentally restructure Medicaid by capping federal…