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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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  • Managed Care For Low-Income Populations with Special Needs: The Tennessee Experience

    Report

    This paper provides a targeted review of Tennessee's experience providing health care to individuals with special needs under TennCare, its Medicaid managed care initiative. The first part reviews the experience of TennCare Partners, the behavioral health carve-out program created in 1996. The second part reviews how TennCare's structure affects the disabled and chronically ill.

  • Employment-Based Health Insurance Coverage and its Decline:-2134

    Report

    Employment-Based Health Insurance Coverage and its Decline:The Growing Plight of Low-Wage Workers This background paper examines the increase in uninsured workers and the growing disparity in health insurance coverage between low- and high-wage workers. While a larger proportion of higher wage workers had health coverage in 1996 than a decade before, coverage deteriorated for low-wage and less-educated workers, especially young men. The paper explores many explanations for this widening disparity. The primary cause is that…

  • Medicaid Eligibility for the Elderly

    Report

    The purpose of this issue paper is to explain Federal Medicaid eligibility policy for the low-income elderly population and discusses Federal and State policy options to improve coverage. Issue Paper

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Fact Sheet

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available. Fact Sheet

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Other Post

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries; describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care. Available in PDF format. Return to top Library Index

  • The Changing Medicaid Managed Care Market

    Report

    Trends in Commercial Plans' Participation This background paper analyzes the trends in commercial plan participation in the Medicaid market by using a database specifically designed for this purpose. It examines changes from mid-1996 to mid-1997 in the types of full-risk plans serving Medicaid Beneficiaries. It also looks at trends through mid-1998 for the 15 states with the largest number of Medicaid enrollees. Background Paper: : Trends in Commercial Plans' Particpation

  • Medicare’s Role for Latinos – (Spanish version)

    Other Post

    Medicare's Role for Latinos - (Spanish version) Note: This publication is no longer in circulation. However, a few copies may still exist in the Foundation's internal library that could be xeroxed. Please email order@kff.org if you would like to pursue this option

  • Medicaid’s Disabled Population and Managed Care

    Other Post

    Medicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them. It also provides information on enrollment in managed care, program features, and issues such as quality assurance, rate setting, and benefits. A detailed report is also available (#2114) Medicaid's Disabled Population and Managed Care

  • Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries

    Other Post

    Medicare Beneficiaries: A Population at RiskFindings from the Kaiser/Commonwealth Fund 1997 Survey of Medicare Beneficiaries Tables for Medicare Beneficiaries: A Population at RiskPart 1 Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane Rowland List of Tables Table 1 Medicare Beneficiary Demographics, by Poverty Status Table 2 Medicare Beneficiary Demographics, by Age Group Table 3 Medicare Beneficiary Demographics, by Supplemental Insurance Type Table 4 Medicare Beneficiary Demographics, by Gender Table 1Medicare Beneficiary Demographics, by…