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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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  • Enrollment Increases in State CHIP Programs: December 1998 to June 1999

    Report

    A new survey of state officials, conducted by Vernon Smith of Health Management Associates for the Kaiser Commission on Medicaid and the Uninsured, found that the number of children enrolled in stateCHIP programs has grown to more than 1.3 million in June 1999 from about 835,000 in December 1998. The survey was released at the July 30th Alliance for Health Reform Briefing on state efforts to enroll more kids in the Children's Health Insurance Program.…

  • Medicare and Low-Income Beneficiaries

    Fact Sheet

    As part of The Faces of Medicare, a collection of fact sheets profiling the characteristics and health needs of different groups of Medicare beneficiaries, highlights key facts about Medicare's low-income population, who have have greater health needs than those with higher incomes. Fact Sheet

  • Medicare and The Under-65 Disabled

    Fact Sheet

    As part of The Faces of Medicare, a collection of fact sheets profiling the characteristics and health needs of different groups of Medicare beneficiaries, Medicare and the Under-65 Disabled highlights key information about Medicare's under-65 disabled, whose disproportionately high rates of health and cognitive problems are compounded by low incomes. Fact Sheet

  • Individuals With Disabilities and their Experiences with Medicaid Managed Care

    Report

    Today, one out of every four disabled Medicaid beneficiaries receives health care through managed care. This Background Paper provides insights into how Medicaid managed care is working for individuals with disabilities, based on the findings from seven focus groups held in Florida and New Mexico. The key findings show that adults and children with disabilities feel alone in managing their health care and that important components of managed care - coordination and gatekeeping role that…

  • Medicaid and Managed Care

    Fact Sheet

    This fact sheet provides an overview of the Medicaid program's increasing reliance on managed care to deliver services. Fact Sheet

  • 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…

  • Health Coverage for Latino Children:  Medicaid and the Children’s Health Insurance Program

    Other Post

    Health Coverage for Latino Children: Medicaid and the Children's Health Insurance Program An overview of Medicaid, the Children's Health Insurance Program (CHIP) and health care coverage for Latino Children. This issue brief was released at a briefing for Hispanic and Latino Media in Los Angeles, CA on June 24, 1999. The briefing is part of a series, Latino Voices for Latino Health: Three Cities, One Vision that is jointly coordinated by the Kaiser Family Foundation…

  • The Key to the Door: Medicaid’s Role in Improving Health Care for Women and Children

    Report

    This article, authored by Diane Rowland, Alina Salganicoff, and Patricia Keenan of the Kaiser Commission on Medicaid and the Uninsured, assesses Medicaid's contributions as a public financing program for health insurance coverage for the poor over the last three decades. It reviews Medicaid's impact on the low-income population and discusses the limitations of the program as a strategy for improving the health of low-income groups. While gaps in coverage and limitations in access persist between…

  • Health Insurance Coverage of Low-Wage Workers

    Fact Sheet

    This fact sheet summarizes the reasons why low-wage workers are less likely to have employer-sponsored health insurance than workers with higher incomes and therefore, are more likely to be uninsured. Fact Sheet

  • Managed Care and Low-Income Populations: Case Study of Managed Care in Maryland

    Report

    This report analyzes Maryland's Medicaid managed care program, HealthChoice, an ambitious and broad-reaching effort to reform the financing and delivery of health care for over 300,000 low-income individuals. Implemented in 1997, HealthChoice contains certain innovative features not found in many other state reform efforts, such as protections for traditional providers and development of a new risk adjustment system. This report is one of a series of reports from The Kaiser/Commonwealth Low-Income Coverage and Access Project.…