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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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  • 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. The report also demonstrates that enrollment of new children continued at roughly the same pace during the second half of 1999 as…

  • 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. This report, produced in collaboration with the UCLA Center for Health Policy Research, examines health insurance coverage and access to physician services among African…

  • 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. This new report updates information to reflect changes in the policy and regulatory environment since that time. Report (.pdf)

  • Building Strong Medicaid Managed Care Programs: A Guide To Help Consumer Advocates Participate in Strengthening HIV/AIDS Provisions in Managed Care

    Report

    This new report, prepared by NAPWA with support of the Foundation, grew out of a key recommendation in the Making Medicaid Managed Care Work report, and is designed to provide people with HIV and their advocates with the tools for understanding Medicaid managed care contracts and for working with states to make them responsive to the needs of people with living with HIV. Report (.pdf)

  • New Report Looks at Health Care Trends in California Compared to Rest of Nation

    Report

    A new chartbook by the Kaiser Family Foundation shows that on most, though not all indicators, California's health care system fares poorly when compared to the U.S. as a whole. The report, Health Care Trends and Indicators in California and the United States, shows that many more Californians have no health insurance than in the rest of the U.S., but when they do have insurance it tends to be more comprehensive and cost less than…

  • Table

    Other Post

    SUMMARY OF CALIFORNIA VERSUS THE U KEY HEALTH CARE FACTS IN CALIFORNIA AND THE U.S. California U.S. Percentage uninsured (non-elderly) (1998) 24.4% 18.3% Percentage of children uninsured (1998) 20.8% 15.5% Percentage of non-elderly enrolled in Medicaid: 1998 11.1% 8.4% 1994 14.3% 10.0% Percentage of employers that offer health insurance (1999) 48% 61% Percentage of workers with access to coverage for "non-traditional" partners (1999) 31% 18% Average monthly HMO premium for family coverage (1999) $405 $445…

  • Medicaid Eligibility for Individuals with Disabilities

    Issue Brief

    This issue paper updates the July 1999 report and provides a general overview of federal Medicaid eligibility policy for the low-income disabled population. This paper focuses on four broad groups of individuals with disabilities: children under 18; adults under 65 who are not living in institutions; adults under 65 who are living in institutions; and adults under 65 who are also eligible for Medicare. In addition, this paper includes the new eligibility options offered under…

  • NewsHour/Kaiser Survey Underscores Difficulties Faced by Those Without Health Insurance

    Report

    The National Survey on the Uninsured from The NewsHour with Jim Lehrer and the Kaiser Family Foundation is this year's first nationwide survey on Americans' attitudes about the growing uninsured population and the difficulties uninsured people face getting medical care. The survey also assesses public attitudes on options to address the problem. News Release: NewsHour/Kaiser Survey Spotlights Misconceptions About the Medically Uninsured National Survey of the Uninsured Toplines/Survey Key Facts Chart Pack Fact Sheet Public…