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5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

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.

Waiting Lists for Medicaid Home Care, 2016 to 2025
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.

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.

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  • Prescription Drugs: Results from a National Survey

    Fact Sheet

    Prescription drugs have become an integral part of medical practice - they help keep people healthy and save lives. But rising prescription drug costs have placed a growing burden on consumers, employers, and public programs. The issue of drug coverage for seniors under Medicare has moved to center stage in the Presidential election.

  • Medicaid and Prescription Drugs

    Fact Sheet

    Summarizes the coverage of outpatient prescription drugs by Medicaid. Many low-income seniors and other Medicaid recipients rely on this benefit as their only means of drug coverage.

  • Health Issues in the 2000 Presidential Election

    Other Post

    A Comparison of Proposals This report presents basic, nonpartisan information to help readers compare the leading presidential candidates' proposals on health care issues, including health coverage for the uninsured, managed care and patients' rights, Medicare reform, prescription drug coverage for seniors, and long-term care.

  • Immigrants’ Access to Health Care

    Issue Brief

    Immigrants account for 20 percent of the uninsured. There are many reasons for immigrants' lack of coverage, but the welfare reform law of 1996 was significant in restricting Medicaid eligibility for certain immigrant populations.

  • Racial and Ethnic Disparities in Access to Health Insurance and Health Care

    Fact Sheet

    Racial and ethnic groups in the United States continue to experience major differences in health status compared to the majority white population. Although many factors affect health status, the lack of health insurance and other barriers to obtaining health services markedly diminish minorities' use of both preventive services and medical treatments.

  • New Numbers on Enrollment of Uninsured Children

    Report

    This report reveals that the total number of children enrolled in state CHIP programs had grown to 1.8 million by December 1999, a 112% increase from December 1998. Although enrollment doubled in 20 states during that year, growth did begin to moderate in several states that had implemented their programs relatively earlier on.

  • Making Medicaid Managed Care Work: An Action Plan for People Living With HIV

    Report

    This is an update of an earlier report also prepared by The National Association of People with AIDS (NAPWA), with support from the Foundation. That report was the product of a 1996 meeting of people with HIV, their advocates, and researchers designed to provide information about Medicaid managed care for people with HIV.