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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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  • State Variations in the Role of the Reproductive Health Safety Net for Contraceptive Care Among Medicaid Enrollees

    Issue Brief

    This KFF analysis uses 2023 T-MSIS Research Identifiable Files to look at where reproductive-age female Medicaid enrollees received their last contraceptive visit by state. Overall, more than four in 10 (43%) female Medicaid enrollees received their last contraceptive visit of 2023 at a safety net provider, which includes Planned Parenthood clinics, community health centers, state and local health departments, and Indian health services, but there is wide variation by state.

  • Potential “Chilling Effects” of Public Charge and Other Immigration Policies on Medicaid and CHIP Enrollment

    Issue Brief

    This issue brief reviews the Department of Homeland Security (DHS) proposed rule that would rescind 2022 Biden-era public charge determination regulations. The proposed public charge changes along with other Trump administration policy changes will likely lead to decreased participation in public programs, including Medicaid, among a broad group of immigrant families, including citizen children in those families.

  • Payment Rates for Medicaid Home Care Ahead of the 2025 Reconciliation Law

    Issue Brief

    Increased payment rates for Medicaid home care workers are states’ key approach to addressing workforce shortages. 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.

  • Eliminating the Medicaid Expansion Federal Match Rate: State-by-State Estimates

    Issue Brief

    This analysis examines the potential impacts on states and Medicaid enrollees of eliminating the 90% federal match rate for the Affordable Care Act (ACA) expansion. Eliminating the federal match rate for adults in the Medicaid expansion could reduce Medicaid spending by nearly one-fifth ($1.9 trillion) over a 10-year period and up to nearly a quarter of all Medicaid enrollees (20 million people) could lose coverage.

  • A 90% Cut to the ACA Navigator Program

    Quick Take

    Cutting funding for the trusted and impartial source of important information Navigators provide could have big impacts just as many consumers may need to re-evaluate their coverage options.

  • The Debate Over Federal Medicaid Cuts: Perspectives of Medicaid Enrollees Who Voted for President Trump and Vice President Harris

    Report

    The Republican-led Congress is considering plans to cut Medicaid to help pay for tax cuts, with the House budget resolution targeting $880 billion or more in potential reductions to federal Medicaid spending. To better understand the experiences of Medicaid enrollees and their perceptions of potential changes to the program, KFF conducted five virtual focus groups in January, including three groups with participants who had voted for President Trump in the 2024 election and two groups with participants who had voted for Vice President Harris.

  • Trump Voters On Medicaid, On Medicaid Cuts

    From Drew Altman

    In a new column, KFF President and CEO Drew Altman discusses how recent KFF focus groups with Trump voters on Medicaid show that voters were not expecting big Medicaid cuts from the Trump administration and worry about what the impact of potential cuts in federal Medicaid spending will be. As Drew writes: “Trump built a populist base of working people formerly in the Democratic party.” When details of specific Medicaid cuts emerge, tension could develop between “Trump and Republicans on the Hill who want to cut entitlement programs that now serve a significant part of Trump’s base.”

  • New Trump Administration Proposals Would Further Limit Gender Affirming Care for Young People by Restricting Providers and Reducing Coverage

    Issue Brief

    This brief examines two proposed federal rules that would further restrict youth access to gender affirming care. One rule would change the hospital Conditions of Participation (CoPs) which would prohibit most Medicare and Medicaid enrolled hospitals from providing certain types of gender affirming medical care for young people and the other would prohibit federal Medicaid or CHIP funds from covering this care. The rules have a 60-day comment period, do no take immediate effect, and are expected to face litigation, if finalized.