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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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  • What Role Do Immigrants Play in The Direct Long-Term Care Workforce?

    Issue Brief

    To increase understanding of how shifting immigration policies may affect the direct care workforce providing long-term care services, this data note uses the 2023 American Community Survey (ACS) to provide an overview of the role that immigrants play in the direct care workforce for long-term care (LTC) services

  • Medicaid and CHIP Eligibility, Enrollment, and Renewal Policies as States Resume Routine Operations

    Report

    A KFF survey of state Medicaid officials examines state Medicaid and CHIP eligibility, enrollment, and renewal policies in place as of January 2025 as states return to routine operations following the unwinding of the continuous enrollment provision. The survey finds that states have broadly adopted policy and system changes to automate and improve the accuracy and efficiency of Medicaid enrollment and renewal processes and provides a baseline of state policies ahead of potential changes to…

  • Decoding the HHS Reorganization

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman examines the implications of Secretary Kennedy’s reorganization of HHS and why it’s a sharp break from past efforts to reorganize the department.

  • Why Most States Will Not Replace Federal Medicaid Cuts

    From Drew Altman

    In his latest Beyond the Data column, KFF’s President and CEO Drew Altman discusses how difficult it will be for states to replace lost federal Medicaid funding should Congress make significant cuts.

  • 5 Key Facts About Medicaid Coverage for People with Medicare

    Issue Brief

    The recently passed House budget resolution targets cuts to Medicaid of up to $880 billion or more over a decade to help pay for tax cuts. Major cuts to Medicaid may impact coverage for the almost 1 in 5 Medicare beneficiaries (12.2 million) who are also enrolled in Medicaid.

  • 5 Key Facts About Medicaid Program Integrity – Fraud, Waste, Abuse and Improper Payments

    Issue Brief

    Program integrity efforts work to prevent and detect fraud, waste, and abuse, to increase program transparency and accountability, and to recover improperly used funds. 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.