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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

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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.

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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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  • Medicaid Enrollment in 50 States: December 2001 Data Update

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    This publication provides state-by-state enrollment information and identifies national trends from the data. Some of the findings include: The rate of Medicaid enrollment growth doubled during 2001. Overall enrollment increased in all 50 states and the District of Columbia, with positive enrollment growth in the categories of families, children and pregnant women as well as the aged and disabled. Data suggest that Medicaid continues to evolve from a welfare-based program to a more traditional health…

  • Medicaid’s Role in Covering Families

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    Medicaid's Role in Covering Families Twelve years ago, the U.S. Congress passed the law requiring that by the end of fiscal year 2002, states would complete a series of incremental steps to ensure all children in families with incomes at or below the federal poverty line would have Medicaid coverage. The day, September 30, has arrived and the Commission put together a brief description of how Medicaid assists low-income American families with their health coverage.…

  • Recent Publications on Medicaid and State Budgets

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    Medicaid is a joint federal-state program in which Federal Medicaid matching payments are projected to be $147 billion FY 2002, while state spending is estimated at about $100 billion. Because Medicaid is such a large part of state budgets and states are struggling with their overall fiscal situations, the Kaiser Commission on Medicaid and the Uninsured continues to follow developments in Medicaid progams related to state budgets. Below are the most recent publications on this…

  • Medicare’s Disabled Beneficiaries: The Forgotten Population in the Debate Over Drug Benefits

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    About 5 million Americans under age 65 qualify for Medicare coverage because they are totally and permanently disabled. They are more likely than the elderly to live in poverty, to be in poor health, and to experience difficulties living independently and performing basic daily tasks. A new study from The Commonwealth Fund and the Henry J. Kaiser Family Foundation, reports that the disabled have few options other than Medicaid for obtaining prescription coverage. In ,…

  • Medicare+Choice in California: Lessons and Insights

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    Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…

  • Nursing Home Staffing Standards

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    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

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    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…