Medicaid

new and noteworthy

5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • This is an image of text that are an excerpt of Larry Levitt's quick take that reads: " Once Republicans in Congress get specific about Medicaid cuts, it will become more tangible and clearer who will be affected. Changes to the status quo in health care rarely get more popular when the details get filled in. We saw that with the Clinton health plan in the 1990s, with the Affordable Care Act (ACA) when it initially passed, and with the 2017 effort to repeal the ACA."

    The Rubber is About to Hit the Road on Medicaid Cuts

    Quick Take

    Once Republicans in Congress get specific about Medicaid cuts, it will become more tangible and clearer who will be affected. Changes to the status quo in health care rarely get more popular when the details get filled in.

  • Understanding Fraud and Abuse in Medicaid

    Event Date:
    Event

    As Congress considers ways to help pay for extending tax cuts, some lawmakers have suggested that hundreds of billions of dollars in federal savings could be achieved by addressing fraud, waste and abuse in the Medicaid program. Three experts joined Health Wonk Shop series moderator Larry Levitt in an hour-long discussion designed to unpack claims about fraud and abuse and put them in a larger context.

  • What Do Medicaid Unwinding Data by Race and Ethnicity Show?

    Policy Watch

    As of September 2023, nine states are reporting data that allow for analysis of disenrollment patterns by race and ethnicity. Five states (Arizona, California, Indiana, Minnesota, and Oregon) provide data on disenrollment rates by race and ethnicity. Four states (Nevada, Oklahoma, Virginia, and Washington) report the distribution of disenrollments by race and ethnicity that can be compared to the distribution of overall Medicaid enrollment in each state by race and ethnicity.

  • Halfway Through the Medicaid Unwinding: What Do the Data Show?

    Policy Watch

    Ten months into the unwinding of the Medicaid continuous enrollment provision, KFF tracking shows that states have reported outcomes for roughly half of the people expected to undergo renewals during the unwinding period. This policy watch examines the latest data and key issues to watch during the next phase of the unwinding.

  • Medicaid: What to Watch in 2024

    Issue Brief

    As the start of 2024, many issues are at play that will affect Medicaid coverage, financing, and access. This issue brief provides context for these Medicaid issues and highlights key issues to watch in the year ahead.

  • Few Nursing Facility Residents and Staff Have Received the Latest COVID-19 Vaccine

    Issue Brief

    KFF analysis found that over one-fifth of all U.S. COVID-19 deaths occurred in long-term care facilities despite but as of January 14th, 2024, only 38% of residents and 15% of staff were “up-to-date” with their COVID-19 vaccines, which the CDC defines as having received the updated Fall 2023 vaccine. Those rates are lower than uptake was for the 2022 vaccine.