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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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  • State Medicaid Officials Anticipate the COVID-19 Public Health Emergency Will End During State FY 2023, Leading to Medicaid Enrollment Declines, Slower Total Medicaid Spending Growth and a Sharp Rise in States’ Share of Costs

    News Release

    After steep gains since 2020, state Medicaid agencies expect Medicaid enrollment to begin to decline in FY 2023, following the expiration of the COVID-19 public health emergency (PHE), which most states assumed would occur during FY 2023, according to KFF’s new state Medicaid budget survey. Projections of declining enrollment tied to the end of the federal continuous enrollment requirement are also expected to translate into slower total Medicaid spending growth in FY 2023. At the…

  • Six Months into the Medicaid Unwinding: What Do the Data Show and What Questions Remain?

    Policy Watch

    Six months into the unwinding of the Medicaid continuous enrollment provision, KFF tracking shows states are reporting outcomes for over 28 million renewals, accounting for three in ten people who were enrolled as of March 2023 when continuous enrollment ended. This policy watch examines the latest data and key questions as the unwinding continues to unfold.

  • Most Nursing Home Staff and Residents Are Not Up to Date with Their COVID-19 Vaccines

    News Release

    As winter approaches, a new KFF analysis finds that less than half (45%) of all nursing facility residents and less than a quarter of staff (22%) are up to date with their COVID-19 vaccinations. That is a sharp drop from the 87 percent of nursing facility residents and staff who completed their primary vaccination series. The U.S. Centers for Disease Control and Prevention (CDC) now defines being up to date as “having received a bivalent…

  • State Policies for Expanding Medicaid Coverage of Community Health Worker (CHW) Services

    Issue Brief

    Community Health Workers (CHWs) are frontline workers who have close relationships with the communities they serve, allowing them to better liaise and connect community members to health care systems. States may authorize Medicaid payment for certain CHW services under state plan or Section 1115 demonstration authority. States may allow or require managed care organizations (MCOs) to provide CHW services or include CHWs in care teams. Many states use CHW services to address the health needs…

  • New KFF Focus Groups Reveal Medicaid Enrollee Experiences During Unwinding

    News Release

    Over six months after the expiration of pandemic-era enrollment protections, at least 27 million Medicaid enrollees—or roughly one-in-three enrollees across the country—have completed their state’s eligibility renewal process for the program. Over 18 million people have had their coverage renewed and over 10 million have been disenrolled, as of November 8, 2023. New KFF focus groups look beneath the numbers at the experiences of enrollees who have gone through the Medicaid renewal process. Drawing from…

  • A Look at State Take-Up of ARPA Mobile Crisis Services in Medicaid

    Issue Brief

    Rising concerns about mental health and substance use disorder have led to new policy initiatives and funding to improve access and quality of services to address mental health crisis. While crisis call centers are accessible nationwide, the availability and characteristics of other components of the crisis continuum--mobile crisis units and stabilization centers--vary across and within states, as does the financing of these systems. The American Rescue Plan Act (ARPA), passed in 2021, had several Medicaid-focused…