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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  • Medicaid Covers People with Pre-Existing Conditions, Too

    Policy Watch

    In recent weeks, the possible overturning of the Affordable Care Act (ACA) in court and the upcoming election have focused attention on the issue of protections for people with pre-existing conditions. While the focus has been on the ACA’s private insurance protections, Medicaid also plays a significant role in covering people with pre-existing conditions.

  • What Happens to Medicaid Drug Policy if the ACA is Overturned?

    Issue Brief

    The repeal of the ACA could mean loss of Medicaid coverage for up to 15 million that were enrolled in the ACA Medicaid expansion group prior to the COVID-19 pandemic; however, repeal could also mean significant changes to Medicaid prescription drug policy with implications for state and federal spending for prescription drugs for non-expansion Medicaid enrollees.

  • Build Back Better Would Reduce Disproportionate Share Hospital (DSH) Payments and Limit Uncompensated Care (UCC) Pools in Non-Expansion States

    Policy Watch

    The Build Back Better (BBB) Act proposes reducing disproportionate share hospital (DSH) allotments by 12.5% starting in federal fiscal year (FFY) 2023 and places limits on Medicaid uncompensated care (UCC) pools for non-expansion states. This policy watch explains what these payments are, what changes have been tied to the ACA, and examines potential implications of changes included in the BBB.

  • State Policies Connecting Justice-Involved Populations to Medicaid Coverage and Care

    Issue Brief

    The COVID-19 pandemic has magnified pre-existing health disparities for justice-involved populations, with coronavirus infection rates among incarcerated populations higher than overall infection rates in nearly all states. Justice-involved individuals are disproportionately low-income and often have complex and/or chronic conditions, including behavioral health needs. Although the statutory inmate exclusion policy prohibits Medicaid from covering services provided during incarceration (except for inpatient services), states may take other steps to leverage Medicaid to improve continuity of care for…

  • COVID-19 Cases and Deaths in Long-Term Care Facilities through June 2021

    Issue Brief

    This data note examines state-level data on COVID-19 cases and deaths in long-term care facilities through June prior to the recent rise in cases and deaths nationally linked to the spread of the Delta variant. It finds long-term care deaths down 96% from their peak in December as the nation's vaccination effort began.

  • 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.