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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 and Uninsured: The Challenge for Extending Coverage

    Event Date:
    Event

    Diane Rowland, executive director of the Commission, testified to the Senate Committee on Finance about the low-income uninsured. The testimony provides a comprehensive description and analysis of the population and discusses the challenges of providing them health coverage. Please note: the video is no longer available.  If you have an urgent need for the video, you may contact us (choose “problem with video” on the form) and we will try to locate the video. Include the…

  • The Basics of Medicaid

    Other Post

    The Kaiser Commission co-sponsored a policy briefing on the basics of the Medicaid program, including eligiblity, financing, and benefits. Links to the presentation slides, fact sheets, and a select legislative history of this coverage program for low-income and disabled individuals are available below. Medicaid 101 Presentation Slides Medicaid Legislative History The Medicaid Program at a Glance Medicaid Enrollment and Spending Trends Medicaid and Managed Care Medicaid and Prescription Drugs Webcast of Policy Briefing

  • Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Medicaid's Role for Low-Income Medicare Beneficiaries An overview that identifies low-income Medicare beneficiaries (dual eligibles), how Medicaid can provide care for them, and the challenges to accessing care. Fact Sheet

  • Covering the Low-Income Uninsured: The Case For Expanding Public Programs

    Issue Brief

    An article in the January/February 2001 issue of Health Affairs by Judith Feder, Larry Levitt, Ellen O’Brien, and Diane Rowland assesses how best to expand health insurance coverage for the low-income uninsured. The article concludes that despite flaws in existing public programs, which can and should be remedied, strengthening programs like Medicaid and CHIP establishes a foundation for truly effective coverage for all low-income Americans. Available at www.healthaffairs.org.

  • Health Insurance Coverage Of Low-Income Women

    Fact Sheet

    Low-income women's high rate of health problems and limited economic resources make access to health care and adequate health insurance coverage particularly important. Health coverage, whether through the private sector or publicly through Medicaid, has been demonstrated to improve access to care for low-income women. However, obtaining coverage is not easy or even possible for many women. Job-based insurance is not always an option for low-income women, despite their high workforce participation. Assistance is available…

  • Medicaid and Managed Care

    Fact Sheet

    This fact sheet provides an overview of the Medicaid program's increasing reliance on managed care to deliver services. Fact Sheet

  • Falling Through the Cracks: Health Insurance Coverage of Low-Income Women

    Report

    Access to health coverage is a challenge for millions of low-income women. Because they are more likely to be low-wage workers and work in industries that don't offer benefits, access to job-based coverage is often problematic. Avenues for assistance are available to some through Medicaid. However, despite the program s broadened focus on children and pregnant women, restrictive income and categorical requirements still leave millions of women ineligible and often uninsured. Recent changes in public…

  • CHIP Program Enrollment: June 2000

    Report

    The report reveals that the total number of children enrolled in state CHIP programs had grown to 2.3 million by June 2000, showing a steady increase in enrollment. The report is part of a larger project to track Medicaid and CHIP enrollment in all 50 states. REPORT Download