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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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  • Federal Budget Chartbook 2001

    Report

    A new chart book examines Fiscal Year 2002 budget proposals by President Bush and Congress, focusing on their impact on health programs. It provides both an examination of how health care programs fit into the overall U.S. budget and a review of past budget trends and future projections for government health care programs. Chartbook

  • 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. In a Commission-sponsored conference call on May 15, experts on immigrant health issues discussed recent findings about how the health system is and is not working for immigrants and their potential policy implications. Audio from the conference call is…

  • 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. The brief lists the panel for a California Health Policy Roundtable held in Sacramento, California on May 4, 2001. Issue Brief

  • 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. This report is one of several appearing on this website from a five-state study of CHIP implementation in California, Connecticut, Maryland, Missouri, and Utah. REPORT Download

  • 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. Nevertheless, when they are asked about it directly, most Americans think that poverty is still a problem in this country, even in these generally prosperous…

  • 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. It also provides information on enrollment in managed care, program features, and issues such as quality assurance, rate setting, and benefits. Fact Sheet

  • 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. Fact Sheet

  • 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. Fact Sheet

  • 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. News Release: Recent Immigrants Have Had Little Impact on the Growth in America's Uninsured Population Issue Paper: Is Immigration Responsible for the Growth in the Number of the Uninsured? Fact Sheet: Immigrants' Health Care Coverage and Access Chart…