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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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  • Medicare Beneficiaries and Their Assets: Implications for Low-Income Programs

    Report

    This report, prepared by Marilyn Moon of The Urban Institute and Robert Friedland and Lee Shirey of Georgetown University's Center on an Aging Society, reviews the income and assets of the current Medicare population, provides an overview of asset tests used to determine eligibility for programs assisting low-income Medicare beneficiaries, and considers how alternative policy…

  • Low-Income Parents’ Access to Medicaid Five Years After Welfare Reform

    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.

  • Acceleration of Medicaid Spending Reflects Mounting Pressures

    Report

    This issue paper reveals that after three years of relatively slow spending growth, Medicaid spending accelerated in 1999 and 2000, and more rapid growth appears likely to continue. Medicaid spending grew by 7.1 percent ind FY 1999 and 8.6 percent in FY 2000.

  • Reaching Uninsured Children Through Medicaid: If You Build It Right, They Will Come

    Report

    This report analyzes enrollment data of recent years and draws on state experiences to outline the key strategies that will lead to successful enrollment in public health coverage programs and finds that improving enrollment in Medicaid drives improved overall enrollment into a state s public coverage programs.

  • Transitional Medical Assistance (TMA): Medicaid Issue Update

    Fact Sheet

    This fact sheet presents the key questions and answers regarding transitional medical assistance as a part of the Medicaid program and its relationship to Temporary Assistance to Needy Families (TANF), the welfare program.

  • Building on Medicaid: What Works and What More Can Be Done?

    Other Post

    The Kaiser Commission on Medicaid and the Uninsured highlighted two new reports at the policy briefing, , and released several related publications at the event. Reaching Uninsured Children Through Medicaid: If You Build It Right, They Will Come (.pdf) Enrolling Children and Families in Health Coverage: The Promise of Doing More (.

  • Medicaid Program Enrollment: Data Update September 2001

    Report

    This report provides current national and state-level data on the number of persons enrolled in Medicaid. In addition to identifying recent trends in Medicaid, this report also examines trends in the various eligibility categories within Medicaid. The report reveals that enrollment in Medicaid increased by 2.2 million individuals, or 8.