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An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid Work Requirements

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 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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  • Nursing Home Staffing Standards

    Report

    This policy brief describes the current federal staffing requirements and how states separately regulate staffing levels in nursing homes. It also presents data showing actual staffing levels in over half of this country's nursing homes exceed the levels that states and the federal government require. Report PDF Download

  • Analyses of Kaiser Permanente Services for Insured Children

    Report

    Analyses of the Child Health Plan and Other Kaiser Permanente Services for Publicly and Privately Insured Children, a new policy brief prepared for the Kaiser Family Foundation and the California HealthCare Foundation by the Institute for Health Policy Studies at U.C. San Francisco, summarizes the results and policy implications of four different analyses comparing the experiences of children enrolled through Kaiser Permanente in the Child Health Plan, Medi-Cal, Healthy Families, and commercial programs. The aggregate…

  • The Wide Circle of Caregiving

    Poll Finding

    The Kaiser Family Foundation helped conduct a national survey of over 1,000 informal caregivers in 1998 to assess the policy issues involved with this new, growing role for many family members and friends. Nearly one of every four adults (23 percent) is an informal caregiver, and, as the American population ages, it is likely families will take on an even greater responsibility to keep their loved ones at home and in communities. The Foundation is…

  • The Role of National Firms in Medicare+Choice

    Report

    This report addresses national managed care firms participation in M+C and the factors influencing their decision processes about M+C products. Based on interviews with executives and senior staff of national managed care firms, this report examines how eight national firms strategically position their M+C product, including the process that firms use when making decisions and the key factors they say most influence their decisions related to participation. Report

  • Welfare, Work and Health Care

    Report

    As the U.S. Congress works on legislation to reauthorize Temporary Assistance for Needy Families (TANF), the nation's welfare program, the Kaiser Commission on Medicaid and the Uninsured cosponsored a briefing on the health-related issues of the reauthorization. Chart Pack: Welfare Reform Reauthorization: A Focus on the Health Issues Summary Comparison of Key Health-Related Provisions in TANF Reauthorization Legislation and Proposals (June 28, 2002) Fact Sheet -- Welfare and Work: How Do They Affect Parents' Health…

  • 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 options would affect eligibility for these programs. The authors find that beneficiaries with low incomes tend to have minimal assets.…