Medicaid

Medicaid work requirements

Tracking the 2025 Reconciliation Law’s 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.

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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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  • The Impact of the Pandemic on Well-Child Visits for Children Enrolled in Medicaid and CHIP

    Issue Brief

    This issue brief examines well-child visit rates overall and for selected characteristics before and after the pandemic began and discusses recent state and federal policy changes that could impact children’s preventive care. More than half of children under age 21 enrolled in Medicaid or CHIP received a well-child visit in 2019, but the share fell to 48% in 2020, the start of the COVID-19 pandemic.

  • SUD Treatment in Medicaid: Variation by Service Type, Demographics, States and Spending

    Issue Brief

    Substance use disorders contribute to a growing number of deaths, yet they often go undiagnosed and untreated. While nearly three-quarters of Medicaid enrollees with a diagnosed substance use disorder utilized some type of treatment service in 2020, medication treatment rates varied widely, being much lower for alcohol use disorder than opioid use disorder, and lower among Black enrollees and youth compared to their counterparts. Treatment rates varied considerably across states and average Medicaid spending for…

  • Is Medicaid Too Big to… Block Grant?

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman examines how the politics around the Medicaid program have changed as it has grown much larger and more popular, making it even tougher to block grant the program to cut federal Medicaid spending and hand it off to the states.

  • The Shifting Sands for State Medicaid Programs Lurking in Our Data

    From Drew Altman

    KFF President and CEO Drew Altman examines the coming squeeze on state budgets and state Medicaid programs, stemming from declining federal matching funds, weakening state revenues, and competing state priorities, and the challenges it poses for states seeking to strengthen their programs and try innovative new approaches.

  • Explainer: How States Are Using Medicaid Waivers to Help Incarcerated Individuals Get Care and Transition Back into Their Communities 

    News Release

    Compared to the general population, individuals who are incarcerated have higher rates of mental illness, substance use disorder, and chronic disease. However, the federal “inmate exclusion” policy prohibits Medicaid coverage for people who are incarcerated (except for limited inpatient hospital services). When people leave incarceration, they are at greater risk of overdose death and suicide, as well as hospitalization and emergency department use.  In a new explainer, KFF examines a new waiver opportunity that allows…

  • Examining New Medicaid Resources to Expand School-Based Behavioral Health Services

    Issue Brief

    In light of worsening mental health among youth, strategies have been implemented to improve access to behavioral health services in recent years, including expanding school-based care for students. Leveraging Medicaid to improve and address gaps in school-based behavioral health services has been a key strategy in recent years as youth mental health concerns have grown. Provisions from the Safer Communities Act of 2022 utilize Medicaid to expand both school-based health care and other mechanisms of…

  • An image of text is an excerpt from Cynthia Cox's quick take which reads, "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits."

    ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

    Quick Insights

    Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even…

  • Will Insurance Cover Over-the-Counter Contraceptive Pills? A Discussion of Coverage Options and Challenges

    Event Date:
    Event

    The U.S. Food and Drug Administration recently approved Opill—the first over-the-counter daily oral contraceptive pill in the United States. Beginning in early 2024, people will be able to purchase Opill without a prescription, expanding options for contraceptive access across the country. On September 15, 2023, a panel of experts joined Laurie Sobel, associate director for KFF’s Women’s Health Policy program, to explore approaches to covering over-the-counter oral contraception without a prescription. The panel discussed lessons…

  • Will Availability of Over-the-Counter Narcan Increase Access?

    Policy Watch

    Making Narcan available OTC has the potential to expand access, but several obstacles may limit its reach. Decisions by pharmacies on whether to stock OTC Narcan, the product's placement within stores, and lingering stigmas can impact accessibility. Furthermore, public knowledge plays a role; many people may not realize that OTC Narcan is available without a prescription from a doctor and that insurance may help cover the costs.