Medicaid

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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • Medicaid 1915(c) Home and Community-Based Service Programs: Data Update

    Issue Brief

    Over the last four years, the Commission has been tracking the national development of the three main Medicaid HCBS programs that states can operate. The Commission also began to survey the policies, such as eligibility criteria and waiting lists that states can use to control the growth of spending on the waiver programs. This brief presents the latest data on the development of home and community-based service programs in Medicaid. Issue Paper (.pdf)

  • Premium Assistance Programs:  How Are They Financed and Do States Save Money?

    Issue Brief

    Premium Assistance Programs: How Are They Financed and Do States Save Money? This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness; and cost savings. Issue Brief (.pdf) Executive Summary (.pdf)

  • Why Does Medicaid Spending Vary Across States: A Chartbook of Factors Driving State Spending

    Report

    This detailed chartbook provides an illustrative overview of some of the key factors that contribute to the substantial variation in Medicaid spending across states today. The chartbook provides a broad range of state-by-state data on subjects including state revenue and spending, the demand for public services, health care markets, and state Medicaid policy choices. Understanding this variation can be important for assessing state fiscal issues, the differences across states and their implications for federal and…

  • Financing Health Coverage:  The Fiscal Relief Experience

    Issue Brief

    Financing Health Coverage: The Fiscal Relief Experience This paper provides an overview of the context which prompted federal fiscal relief to the states in 2003 and discusses the implications of this experiment in federal intervention for financing the Medicaid program. Policy Brief (.pdf)

  • Long-Term Care:  Understanding Medicaid’s Role for the Elderly and Disabled

    Issue Brief

    Long-Term Care: Understanding Medicaid’s Role for the Elderly and Disabled This updated report provides a review of how Medicaid works for people with long-term care needs and describes the fiscal challenges that states currently face and that Medicaid may face in the future as the population ages. Report (.pdf) Executive Summary (.pdf)

  • New Reports Explain Medicaid’s Role in Long-Term Care and Track Trends

    Issue Brief

    With short and long-term policy changes to the Medicaid program being discussed, its role in providing long-term care is receiving closer examination. Medicaid is the single largest source of financing for long-term care, accounting for nearly half of all the nation’s spending for long-term care services, and demographic trends are likely to place additional pressure on Medicaid. New attention is being focused on who relies on Medicaid for help with nursing home bills and how…

  • An Implementation Perspective on Part D, the Medicare Prescription Drug Program

    Report

    This focus group of 12 state Medicaid officials conducted in November 2005 explores the current status and likely results of the Part D dual eligible transition efforts as well as other Part D-related issues of particular importance to states. It includes discussion of the transition of dual eligibles from Medicaid to Medicare drug coverage, evaluating Part D plan options, states’ role in the low-income subsidy program, the fiscal implications of Part D to states, and…

  • Child Health Facts: National and State Profiles of Coverage

    Report

    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

  • New Kaiser Resources Examine Medicaid as a Platform for Health Reform

    Issue Brief

    These related research papers examine the policy opportunities for expanding Medicaid to cover more low-income and high-need people in ways that would enable the program to serve as a platform for larger national health reform efforts. As congressional leaders work on proposals for universal coverage, some policymakers have suggested that strengthening Medicaid’s coverage of the poorest Americans and those with special health needs could provide a base for broader health reform efforts to expand coverage,…

  • Examing the Role of Private Long-Term Care Insurance in the Financing of Long-Term Care

    Issue Brief

    As the long-standing gap between Americans’ need for long-term care services and the public and private funding available to pay for them grows ever wider, this policy brief from the Kaiser Commission on Medicaid and the Uninsured examines the fundamentals of private long-term care insurance. The brief describes the results of a study exploring how consumers buy policies, how much policies cost and how they work, and what regulations exist to protect consumers. It also…