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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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  • 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. Policy Brief

  • 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 8.7 percent annualized, in the first nine months of 2001. Report

  • Enrolling Children and Families in Health Coverage: The Promise of Doing More

    Report

    The 50 state survey of enrollment simplification and renewal procedural reforms, shows that states continue to take steps to transform the Medicaid program from its origins as a welfare-based program into something resembling a more traditional health insurance program. Report (.pdf) >>All 50-State Children's Health Coverage Reports

  • SCHIP Program Enrollment: December 2001 Update

    Report

    This report presents information on the number of children enrolled in SCHIP for each state, for specific months from 1998 to 2001. As of December 2001, the SCHIP program covered 3.5 million low-income children. An increase of 780,000 from the previous year. REPORT Download

  • 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. REPORT Download

  • 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. Fact Sheet

  • 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 (.pdf) Medicaid Program Enrollment: Data Update September 2001 (.pdf) SCHIP Program Enrollment: December 2001 Update (.pdf) Acceleration of Medicaid Spending Reflects Mounting Pressures (.pdf) Medicaid Update: What Changes Are…

  • 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.

  • Survey on Health Care

    Other Post

    NPR/Kaiser Family Foundation/Harvard Kennedy School of Government Survey on Health Care A survey by NPR, the Kaiser Family Foundation, and Harvard s Kennedy School of Government finds that many Americans have real problems when it comes to accessing and paying for health care, and even if they haven't yet faced a problem, many worry about getting and paying for care in the future. The survey also shows that, while people think helping seniors with the…