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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  • The COVID-19 Pandemic Has Taken a Higher Toll on Nursing Homes with Relatively High Shares of Black or Hispanic Residents

    News Release

    Nursing homes with a relatively high share of Black or Hispanic residents are more likely to have had a resident die of COVID-19 than homes with lower shares of such residents, finds a new KFF analysis. Nationwide, 63 percent of nursing homes with a relatively high share of Black residents reported one or more COVID-19 death, as did 55 percent of nursing homes with a relatively high share of Hispanic residents, finds the analysis. That…

  • Federal Medicaid Outlays During the COVID-19 Pandemic

    Issue Brief

    This data note analyzes federal Medicaid outlays before and during the COVID-19 pandemic. In the one year since the onset of the pandemic, federal Medicaid outlays totaled $500.8 billion and grew by 19.5%, compared to 6.3% growth in the one year before the pandemic.

  • CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

    Issue Brief

    On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.

  • States Look to Bolster Maternal Health

    Feature

    Starting April 1, states have a new option to extend Medicaid postpartum coverage from 60 days to 12 months without having to seek a waiver.

  • Medicaid Administrative Data: Challenges with Race, Ethnicity, and Other Demographic Variables

    Issue Brief

    There are persistent disparities in health and health care for people of color, which reflect structural and systemic inequities rooted in racism and discrimination. High-quality comprehensive data are key to enabling policymakers, community leaders, and other key stakeholders to identify and address these inequities and measure progress over time. Medicaid/CHIP administrative data, also known as Transformed Medicaid Statistical Information System (T-MSIS) or TAF (T-MSIS Analytic File), hold the potential to inform disparities research through detailed…

  • The Impact of the COVID-19 Recession on Medicaid Coverage and Spending

    Issue Brief

    Unlike previous recessions in modern history, this past recession was spurred by the spread of a virus (COVID-19), which created a public health crisis with unique health implications. This brief describes the broader impacts of this most recent recession – which lasted from February 2020 to April 2020 -- and also explores how trends in Medicaid spending and enrollment differed from past recessions and what that might mean for state Medicaid programs moving forward.

  • Unwinding of the PHE: Maintaining Medicaid for People with Limited English Proficiency

    Issue Brief

    Provisions in the Families First Coronavirus Response Act (FFCRA) require states to maintain continuous Medicaid enrollment for enrollees until the end of the month when the COVID-19 public health emergency (PHE) ends. When the continuous enrollment requirements end and states resume redeterminations and disenrollments, individuals with LEP may be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing these processes, even if they remain eligible for coverage.

  • How Many Medicaid Enrollees Moved In 2020 And What Are The Implications For Unwinding the Public Health Emergency?

    Issue Brief

    Once states resume redeterminations and disenrollments at the end of the public health emergency (PHE), Medicaid enrollees who moved within a state during the pandemic but are still eligible for coverage are at increased risk of being disenrolled if their contact information is out of date. We analyzed federal survey data for 2020 and found that roughly 1 in 10 Medicaid non-elderly enrollees (9%) moved in-state in 2020. A much smaller share, just 1%, moved…