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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s 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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  • SCHIP Administration and Accountability

    Report

    The third in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that non-Medicaid S-CHIP programs faced more administrative challenges. Success with enrollment appeared primarily related to administrative decisions, including a lower band of S-CHIP income eligibility, and the lack of premiums. REPORT Download

  • Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Medicaid's Role for Low-Income Medicare Beneficiaries An overview that identifies low-income Medicare beneficiaries (dual eligibles), how Medicaid can provide care for them, and the challenges to accessing care. Fact Sheet

  • Bush Administration Medicaid/SCHIP Proposal

    Report

    In January 2003, the Bush Administration put forth a proposal to restructure Medicaid and SCHIP in ways that could fundamentally alter the two programs. This policy brief provides a detailed explanation of what is known about the key elements of the proposal and includes a discussion of the proposal's implications. Issue Paper

  • Barriers to Medicaid Enrollment for Seniors: Findings from 10 Focus Groups with Low-Income Seniors

    Report

    Medicaid coverage substantially improves access to health care and lessens the financial burden of medical care for low-income seniors, but the program currently reaches only half of all poor Medicare beneficiaries. This report presents findings of focus groups with low-income seniors in an effort to understand barriers to enrollment for those who are eligible for Medicaid but who are not enrolled in the program, and to learn about the experiences of low-income seniors who are…

  • Medicaid and the Prescription Drug Benefit

    Issue Brief

    This policy brief includes background information on Medicaid and its drug benefit, provides examples of how states are using the cost containment mechanisms at their disposal and addresses issues surrounding beneficiary access to outpatient drugs. Policy Brief

  • Reaching Uninsured Children Through Medicaid: If You Build It Right, They Will Come

    Report

    This report analyzes enrollment data of recent years and draws on state experiences to outline the key strategies that will lead to successful enrollment in public health coverage programs and finds that improving enrollment in Medicaid drives improved overall enrollment into a state s public coverage programs. REPORT Download

  • Child Health Facts: National and State Profiles of Coverage – Report

    Other Post

    Child Health Facts: National and State Profiles of Coverage Nearly 10 million children in the United States lack health insurance coverage and over two-thirds of them or low-income. This databook provides baseline data on how many children are uninsured today and on the extent of Medicaid coverage. It provides astarting point to monitor and assess state efforts to reach and insure more children. Report Report

  • How Well Does the Employment-Based Health Insurance System Work for Low-Income Families?

    Other Post

    Part 2 Even when insurance is offered to low-wage workers, its costs to these workers may be substantial, and, for some, a barrier to coverage. In 1996, workers had to contribute an average of $1,615 per year for family coverage, or about 30% of the total premium.5 Thus, a worker who earned $10 an hour in 1996, with annual wages of about $20,000, would have had to spend 8% of earnings to buy family coverage.*…