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Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies.

Medicaid Budget Survey

Medicaid Home Care

Using data from the 23rd KFF survey of officials administering Medicaid home care programs, 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.

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. The data come from KFF’s 23rd survey on Medicaid home care programs in all 50 states and DC.

KFF regularly surveys states about their Medicaid home- and community-based services (HCBS) programs and their eligibility policies for people who are eligible for Medicaid on the basis of having a disability or being 65 and older.

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This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.

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.

The Essentials

  • 5 Facts: Immigrants and Medicaid

    This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.

  • 5 Facts: Medicaid and Hospitals

    This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.

  • Medicaid Financing: The Basics

    Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.

  • 5 Facts: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 5 Facts: Medicaid and Nursing Facilities

    The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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  • Immigrant Health Care Conference Call

    Report

    Federal and state policymakers face a major challenge in addressing the health needs of an increasingly diverse population. That challenge can be even greater in the growing number of cities and states with large immigrant communities.

  • National Survey on Poverty in America

    Poll Finding

    Americans aren't thinking a lot about the poor these days. A new survey by NPR, the Kaiser Family Foundation, and Harvard University's Kennedy School of Government found that only about one in 10 Americans names poverty, welfare, or something similar as one of the two top issues government should address.

  • S-CHIP Implementation in California

    Report

    This report examines the design and implementation of California's State Children's Health Insurance Program (known as Healthy Families), including contracting issues, program design and administration, and access to care by adolescents and children with special health care needs.

  • Employer-Sponsored Health Insurance in California: Current Trends, Future Outlook, and Coverage Expansions — Issue Brief

    Issue Brief

    A 4-page issue brief that looks at trends in employer-sponsored health insurance coverage in California. The brief also includes public and private sector strategies for expanding employment-based coverage, and discusses how other states have implemented incremental coverage expansions using public programs and financial incentives, with emphasis on New York State.

  • Medicaid’s Disabled Population and Managed Care

    Fact Sheet

    Medicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them.

  • The Uninsured in Rural America

    Fact Sheet

    Summarizes the number of uninsured individuals in rural America, who they are, and the barriers to coverage they experience.

  • Medicaid’s Role for the Disabled Population Under Age 65

    Fact Sheet

    Medicaid's Role for the Disabled Population Under Age 65 Defines the non-elderly disabled and summarizes Medicaid's role in their health care coverage. Includes a description of enrollment requirements, benefits, spending and managed care concerns for the population.

  • Immigrants’ Health Coverage and Access

    Report

    New and recent publications on immigrant health policy explore some of the complex problems the country faces in expanding health coverage to immigrants and provide basic statistics and facts on the current status of their health care.

  • Incremental Ways to Cover the Uninsured

    Other Post

    The Kaiser Commission co-sponsored a policy briefing on America's uninsured population and potential models for coverage expansion. Expanding public programs and providing tax credits are both being discussed as ways to cover some of the 42 million uninsured Americans. A link to the webcast and related resources is provided.