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 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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  • Recent Tax Proposals to Increase Health Insurance Coverage

    Other Post

    This report includes a side-by-side analysis of recent tax proposals by Members of Congress and various health organizations designed to increase the number of individuals with private health insurance coverage. Recent Tax Proposals To Increase Health Insurance Coverage

  • Medicaid and Children: Overcoming Barriers to Enrollment

    Report

    Findings from a National Survey This national telephone survey of low-income parents represents a major effort to better understand the barriers to Medicaid enrollment and to test the usefulness of ideas to facilitate enrollment in a quantitative way. Examining both parents of uninsured children who appear eligible for Medicaid and parents with children currently enrolled in Medicaid, the survey findings present: a profile of low-income, Medicaid-eligible children; parents' Medicaid knowledge and perceptions; key barriers to…

  • Express Lane Eligibility: How to Enroll Large Groups of Eligible Children in Medicaid and CHIP

    Report

    This issue paper explores the potential for increasing enrollment in children's health insurance programs through "Express Lane Eligibility." Express Lane Eligibility is the accelerated enrollment of low-income uninsured children already participating in other income-comparable publicly funded programs, such as WIC or school lunch, into Medicaid or CHIP. The paper reviews Express Lane Eligibility's potential impact on Medicaid and CHIP enrollment, analyzes different models, discusses key challenges with implementation, and suggests steps states and localities can…

  • Variations in State Medicaid Buy-in Practices for Low-Income Medicare Beneficiaries: A 1999 Update

    Report

    This report updates a 1997 Foundation report to assess how states are implementing financial protections for the 16 million Medicare beneficiaries who are low-income. These protections, generally referred to as "buy-in programs," help low-income Medicare beneficiaries meet Medicare's cost-sharing requirements by using state Medicaid programs to pay either all or some portion of premiums, deductibles, and coinsurance amounts. Using information collected through a survey of state Medicaid directors and consumer advocates, the update seeks to…

  • Managed Care and Low Income Populations in Texas: 1996-1998 Update

    Report

    This report, Managed Care and Low-Income Populations in Texas: 1996-1998 Update, updates our 1996 case study of Texas' Medicaid managed care initiatives and their affect on low-income populations. The authors conclude that Medicaid managed care in Texas has had mixed results. It is one of a series of reports from the Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid program have affected health insurance coverage and access to…

  • Managed Care and Low-Income Populations in Florida: 1996-1998 Update

    Report

    This report, Managed Care and Low Income Populations in Florida: 1996-1998 Update, updates our 1996 case study of Florida's Medicaid managed care initiatives and their effect on low-income populations. The focus of this report is on how the program has matured and how it has affected access to care and the safety net. It is one of a series of reportsfrom the Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in…

  • Long-Term Care:  Medicaid’s Role and Challenges

    Issue Brief

    Long-Term Care: Medicaid's Role and Challenges This Policy Brief examines Medicaid's role in providing long-term care services. It describes long-term care services, the population that needs these services, and how people get long-term care services. It provides an overview of health insurance coverage of persons with long-term care needs and describes both Medicare's and Medicaid's role in providing these services. It also examines some of the policy issues and challenges involved in providing long-term care…

  • The Difference Different Approaches Make: Comparing Proposals to Expand Health Insurance

    Report

    The Difference Different Approaches Make: Comparing Proposals to Expand Health Insurance This paper estimates and compares the impacts of alternative mechanisms for expanding health insurance coverage. A variety of approaches-expansions of existing public programs, direct subsidies, and tax credits-and target populations-including children, poor adults, parents of Medicaid- or CHIP-covered children, and early retirees-are considered. The impacts of the proposals on coverage, costs and other program outcomes are compared. This paper is part of the Kaiser…

  • Medicaid and Welfare Reform: States’ Use of the $500 Million Federal Fund

    Report

    This report reviews how states have responded to the $500 million federal fund that was created by the federal welfare reform legislation in 1996 to help states maintain Medicaid coverage for individuals affected by welfare reform. State Medicaid officials were asked whether they have drawn down federal funds from the $500 million fund; to describe the factors that influenced their decision; and what activities they are supporting with the additional federal monies. The paper describes…

  • The New Child Health Insurance Program: A Carefully Crafted Compromise

    Report

    This paper explores the major policy compromises embodied in the CHIP program. It focuses on two areas: the relative control of the federal and state governments over the program, and the design of the program in relation to the private, employer-based health insurance market.This paper is part of the Kaiser Incremental Health Reform Project. Issue Brief (.pdf)