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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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  • Public Health in a Changing Health Care System: Linkages Between Public Health and MCOs In the Treatment and Prevention of STDs

    Report

    Public health agencies and managed care organizations share responsibility for the health of the populations they serve. Their relationships are particularly important in the area of STDs. This study analyzes the evolving relationships between managed care organizations and public health agencies in how they manage the prevention, treatment, and tracking of STDs.

  • Public Opinion Update-3006-Public-Opinion-Update

    Other Post

    Public Opinion Update Public Opinion Update Public Opinion Update THE UNINSURED The debate over how to expand health insurance coverage to the over 44 million Americans without it continues to be one of the most challenging issues facing policymakers today.

  • The Public Opinion Update on The Uninsured

    Other Post

    Kaiser Public Opinion Update, April 2000 summarizes key findings from past surveys on the uninsured conducted by the Kaiser Family Foundation and the Harvard School of Public Health and a new survey conducted by the Foundation in conjunction with The NewsHour with Jim Lehrer.

  • Medicaid-Related Provisions in the Ticket to Work and Work Incentives Improvement Act of 1999

    Report

    In December, the President signed into law the Ticket to Work and Work Incentives Improvement Act of 1999, which includes provisions that will give states additional options for extending Medicaid coverage to working disabled individuals. This memo presents an overview of the eligibility options offered under the new legislation (Publication #2187).

  • The Olmstead Decision: Implications for Medicaid

    Issue Brief

    In June, 1999, the Supreme Court rule in Olmstead v L.C. that states were required to provide services to persons with disabilities in community settings rather than institutions, if certain conditions were met. This Policy Brief provides an overview of the Olmstead case, including the facts, the court ruling, and the disposition of the case.

  • Join the Debate: Health Issues in the 2000 Election

    Other Post

    Developed as part of a nonpartisan public education initiative of the Henry J. Kaiser Family Foundation and the League of Women Voters Education Fund, this guide provides basic facts about five key health policy topics candidates are discussing in the 2000 election.

  • Access to Care for Low-Income Women: The Impact of Medicaid

    Issue Brief

    Health coverage is of critical importance to low-income women. This study was undertaken to assess how low-income women with Medicaid, private insurance, or no insurance vary with regard to personal characteristics, health status, and health utilization.

  • Continued Slow Growth for Medicaid Spending in 1997

    Report

    This issue paper provides an overview of Medicaid spending in 1997. Beginning with a recap of spending and enrollment trends since the early 1990s, the authors report that Medicaid spending grew by 4.1 percent between 1996 and 1997, continuing the recent trend of slow spending growth.

  • Health Centers’ Role as Safety Net Providers for Medicaid Patients and the Uninsured

    Report

    This issue paper profiles the role America's health centers have played in providing care for Medicaid patients and the uninsured. The paper presents information on health center patients and revenue sources and analyzes similarities and differences both between health centers and private practices and among health centers.