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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  • How Will Uninsured Parents Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured parents and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Building an Express Lane Eligibility Initiative: A Roadmap of Key Decisions for States

    Issue Brief

    The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provides states new options to reach and enroll the estimated 5 million eligible but uninsured low-income children into Medicaid and CHIP. One key tool provided to states by the law is Express Lane Eligibility (ELE), which allows state Medicaid and CHIP agencies to borrow and rely on eligibility findings from other need-based programs, such as Head Start and the National School Lunch Program, to determine…

  • Medicaid and Budget Reconciliation:  Implications of the Conference Report

    Issue Brief

    Medicaid and Budget Reconciliation: Implications of the Conference Report This issue brief provides an overview of the federal budget context and then highlights key Medicaid savings proposals in the budget reconciliation conference bill and discusses the implications of the proposed changes. Issue Brief (.pdf)

  • A Guide to the Medicaid Appeals Process

    Issue Brief

    This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services, but the process is multi-layered and can be complex to navigate. The guide describes Medicaid's appeals system, including the fair hearing process and the appeals…

  • The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers

    Fact Sheet

    For many years, Section 1115 waivers have been used in the Medicaid program to provide states an avenue to test and implement coverage approaches that do not meet federal program rules, but there have been longstanding concerns about the lack of public input and transparency in the waiver approval process. As a result, the Affordable Care Act required the Department of Health and Human Services to issue regulations designed to ensure that the public has…

  • How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

    Issue Brief

    This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will be wide state variation. The paper presents data showing how states compare in their 2012 Medicaid fee levels, how Medicaid fees compared to Medicare fees,…

  • State-Specific Section 1115 Waiver Fact Sheets

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured is closely following waiver activity to provide information on how these waivers are impacting the uninsured and affecting Medicaid and SCHIP and the coverage provided to low-income beneficiaries. Tennessee Section 1115 Waiver Amendment Proposal Fact Sheet California Section 1115 Waiver Fact Sheet Colorado Section 1115 Waiver Fact Sheet Delaware Section 1115 Waiver Fact Sheet Illinois Section 1115 Waiver Fact Sheet Maine Section 1115 Waiver Fact Sheet New…

  • National Survey of Public Knowledge of Welfare Reform and the Federal Budget

    Poll Finding

    Survey Shows "Two Faces" Of Public Opinion On Welfare Reform Americans Support Time Limits and Tough Work Requirements, But Reluctant to Abandon Those In Need Public Defines Welfare Broadly Understands Key Details of Welfare Programs Embargoed for release: 9:00 a.m. EST, Thursday, January 12, 1995 For further information contact: Matt James or Tina Hoff Menlo Park, CA -- A new Kaiser/Harvard survey of Americans nationwide has found that the public supports strong welfare reform measures,…

  • Kaiser Family Foundation/Field Institute Survey of Californians on the Health Care Initiatives, Propositions 214 and 216

    Report

    Results of two surveys that track Californian's knowledge of the two initiatives on the California Ballot, Propositions 214 and 216 (also known as the Patient Protection Acts) and attitudes towards them as the debate unfolds. The surveys were conducted from August 14-21, 1996 and from September 23-30, 1996. Also included with this material is data on how much is being spent on television advertising for and against the propositions and who is being reached by…

  • The President’s FY 2007 Budget Proposal: Overview and Briefing Charts

    Report

    This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget. Overall, the budget includes net reductions for Medicare, Medicaid, and other health programs administered by the Department of Health and Human Services. The budget also includes additional expenditures for proposals to…