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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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  • 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

  • Post-Election Survey: The Public and the Health Care Agenda for the New Administration and Congress

    Poll Finding

    This Kaiser Family Foundation-Harvard School of Public Health survey, conducted immediately after the 2000 Presidential election, finds that health care issues ranked near the top of voters priorities for spending the surplus. Medicare ranked among the top three priorities, along with education and Social Security, and ahead of paying off the national debt and cutting taxes. Education ranked first. The survey also found that voters support patients rights legislation and some action to help the…

  • Parents’ Views of Children’s Health Insurance Programs: A Survey of Denied Applicants for Kaiser Permanente’s Child Health Plan

    Poll Finding

    In 1997, Kaiser Permanente launched the Child Health Plan to provide subsidized health insurance for low income California children not eligible for Medi-Cal (California's Medicaid program) or Healthy Families (California's State Children's Health Insurance Program). As part of a broader evaluation of the Child Health Plan funded jointly by the Kaiser Family Foundation and the California HealthCare Foundation, these reports provide findings from a survey of low income parents who were eligible for Medi-Cal or…

  • Enabling Services: A Profile of Medicaid Managed Care Organizations

    Report

    The report provides basic statistics on Medicaid managed care organizations providing enabling services - transportation, translation, education, and case management. The report also identifies the extent of variation across plans. REPORT Download

  • Access to Care for S-CHIP Children with Special Health Needs

    Issue Brief

    A study of California, Connecticut, Maryland, Missouri, and Utah CHIP programs show that the states have features in place for special needs children, but problems of provider availability and service authorization did sometimes occur. This is the first in a series of reports on implementation issues and challenges in the first year of CHIP. ISSUE BRIEF Download

  • Immigrants’ Access to Health Care After Welfare Reform:  Findings from Focus Groups in Four Cities-1608

    Report

    Immigrants' Access to Health Care After Welfare Reform: Findings from Focus Groups in Four Cities A new analysis of focus groups in Los Angeles, Miami, New York, and San Antonio reveal immigrants' knowledge of and attitudes toward public programs such as Medicaid and CHIP. Themes explored include current health coverage, participation in programs, barriers to enrollment, and access to care. Report

  • Medicaid and Prescription Drugs: An Overview

    Report

    This background paper discusses the coverage of prescription drugs through the Medicaid program. Some of the issues addressed include who is eligible to receive drugs, how drug coverage is paid for, and how much money states spend on drugs. Background Paper