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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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  • Key Facts: Women and Medicare

    Report

    Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Today, 22 million women one in five adult women rely on Medicare for basic health insurance protection. In fact, women comprise 57% of the Medicare population. Medicare helps to make health care more affordable for older women at a time in their lives when they are most likely to…

  • Women and Medicare:  Making the Connection

    Other Post

    Women and Medicare: Making the Connection This briefing examines Medicare s role in meeting older women's health needs, the gaps in Medicare's benefits package for women, and the emerging debate over prescription drug coverage and Medicare reform.

  • Women and Medicare

    Fact Sheet

    Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Because women have longer life expectancies than men, more than half (57%) of the people covered by the program are women. In 1999, there were 21 million women on Medicare 19 million ages 65 and over and another 2 million women under age 65 with disabilities who received Social…

  • The Henry J. Kaiser Family Foundation

    Other Post

    Marketing Medicaid and CHIP: Connecticut CaliforniaMontanaTexasConnecticutNew JerseyUtahFloridaNew MexicoVirginiaHawaiiNew YorkWashingtonIllinoisNorth DakotaWisconsinKansasOklahomaMissouriPennsylvania

  • Covering the Low-Income Uninsured: Assessing the Alternatives

    Report

    This issue brief describes and analyzes expansions of Medicaid and SCHIP, tax credits for individually-purchased insurance, and tax credits for employment-based health insurance as options to expand health coverage of the low-income population. Issue Paper

  • Restructuring Medicaid Financing: Implications of the NGA Proposal

    Report

    An analysis of the National Governors Association proposal to restructure Medicaid, including the financial impact of the core of the proposal. The report considers possible responses to the reforms and outlines some issues to consider as policymakers think about reforming the program.

  • SCHIP Managed Care Contracting

    Report

    The fourth in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that states have been able to enter arrangements with plans for their S-CHIP population fairly easily. REPORT Download

  • SCHIP Administration and Accountability

    Report

    The third in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that non-Medicaid S-CHIP programs faced more administrative challenges. Success with enrollment appeared primarily related to administrative decisions, including a lower band of S-CHIP income eligibility, and the lack of premiums. REPORT Download