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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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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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  • Restructuring Medicaid: Key Elements and Issues in Section 1115 Demonstration Waivers

    Issue Brief

    This policy brief provides background on Section 1115 Medicaid waiver activity, discusses the common provisions of the approved and proposed Section 1115 waivers since 1993, and briefly summarizes the current application of Section 1115 AFDC waivers. It also examines implications of the Section 1115 waivers on the Medicaid program and its beneficiaries. Policy Brief: Restructuring Medicaid: Key Elements And Issues In Section 1115 Demonstration Waivers

  • Statewide Medicaid Managed Care Demonstrations under Section 1115 of the Social Security Act:

    Report

    A Review of the Waiver Applications, Letters of Approval and Special Terms and Conditions This background paper provides a summary of the key features of the Medicaid 1115 waivers that have been approved, proposed, implemented and conditionally rejected. This July version updates Medicaid 1115 Demonstration Waivers: Approved and Proposed Activities as of February 1995, as well as policy briefs on Medicaid waivers released in August and November of 1994. Report: Statewide Medicaid Managed Care Demonstrations…

  • Native Americans and Medicaid: Coverage and Financing Issues

    Other Post

    Native Americans and Medicaid:Coverage and Financing Issues Medicaid as Medicare Premium Assistance The Medicare program provides health insurance coverage for the nation's elderly and disabled.16 To enroll in Medicare Part B, which offers coverage for physician and other outpatient care, individuals must be 65 or older or must be disabled, and must pay a monthly premium. This monthly premium, which is generally deducted from an individual's Social Security check, is $43.80 per month in 1997.…

  • Participation in Welfare and Medicaid Enrollment

    Other Post

    Part 2 In addition to the state exit studies,24 another source of evidence about the impacts of loss of cash assistance can be found in the set of evaluations of the impacts of welfare-work initiatives. Several program evaluations contain data which may suggest that one unintended consequence of state efforts to increase employment among families receiving assistance could be a decline in health care coverage: The National JOBS Program Evaluation measured the impacts of employment…

  • Enrolling Children and Families in Health Coverage: The Promise of Doing More

    Report

    The 50 state survey of enrollment simplification and renewal procedural reforms, shows that states continue to take steps to transform the Medicaid program from its origins as a welfare-based program into something resembling a more traditional health insurance program. Report (.pdf) >>All 50-State Children's Health Coverage Reports

  • The Faces of Medicare

    Fact Sheet

    The Medicare beneficiary population is often described in homogenous terms, yet those covered by the program vary significantly in terms of their health, income, supplemental insurance status, and medical service use. profiles the following six groups within the Medicare population, providing basic information, trends and data: Healthy retirees, who represent less than 10 percent of the total Medicare population, but sometimes are portrayed as typical of all seniors, Under-65 disabled beneficiaries, whose disproportionately high rates…

  • The Arizona Health Care Cost Containment System: Thirteen Years of Managed Care in Medicaid

    Other Post

    This report provides an overview of the Arizona Medicaid experience and contains valuable insights into the evolution and experience of a mandatory statewide Medicaid managed care program covering both acute care and long-term care services. Note: This publication is no longer in circulation. However, a copy may still exist in the Foundation's internal library that could be reproduced. Please email order@kff.org if you would like to pursue this option.