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An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid Work Requirements

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 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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  • Primer on the Federal Budget, July 1997

    Report

    This report provides information on key budgetary facts and trends and highlights federal spending in health care programs. It includes an overview of federal revenues and spending in fiscal year 1995, an overview of the budget "window" from fiscal year1996 through fiscal year 2002, and the historical context for the budget debate, from fiscal 1973 through fiscal year 2002. Chartbook: Primer on the Federal Budget

  • Children’s Health Insurance: 1997 Budget Reconciliation Provisions – Report

    Report

    Children's Health Insurance: 1997 Budget Reconciliation Provisions (as of 07/14/1997) Center of Health Policy Research and The George Washington University Medical Center Current Law And StatusHouse BillSenate BillI.Status Recommendations transmitted 06/12/97 from Commerce Committee to Budget Committee. H.R. 2015 passed House 06/25/97. Recommendations transmitted 06/19/97 from Finance Cte to Budget Cte. H.R. 2015 (spending bill) and H.R. 2014 (tax bill) as passed by the Senate 06/25/97 and 06/27/97. II.General Approach No systematic approach to financing…

  • The Medicaid Reform Debate in 1997

    Report

    This report has been prepared for the Kaiser Commission on the Future of Medicaid as part of the Urban Institute's ongoing analytic work for the Commission. Report:

  • Statewide Medicaid Managed Care Demonstrations under Section 1115 of the Social Security Act:

    Report

    A Review of the Waiver Applications, Letters of Approval and Special Terms and Conditions This background paper provides a summary of the key features of the Medicaid 1115 waivers that have been approved, proposed, implemented and conditionally rejected. This July version updates Medicaid 1115 Demonstration Waivers: Approved and Proposed Activities as of February 1995, as well as policy briefs on Medicaid waivers released in August and November of 1994. Report: Statewide Medicaid Managed Care Demonstrations…

  • Medicaid and Managed Care: Implications for Low-income Women

    Report

    This commentary reviews Medicaid's role for low-income women and examines the implications Medicaid managed care on the delivery of health services to this vulnerable population. Today 40% of the Medicaid population, mostly poor women and their children, is enrolled in managed care. Medicaid agencies are hoping managed care will control spending and address longstanding problems with access to care. Low-income women have a number of characteristics that make them doubly vulnerable to have trouble accessing…

  • Managed Care And Low-Income Populations: A Case Study of Texas

    Report

    This study is part of a larger initiative, funded by both the Henry J. Kaiser Family Foundation and The Commonwealth Fund. Case studies of seven states that are restructuring their health care systems for the Medicaid and uninsured populations: California, Florida, Minnesota, New York, Oregon, Tennessee, and Texas, are designed to provide early insights and timely analyses that will help states and other efforts shape rapidly evolving managed care systems and health reform programs for…