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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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  • Testimony on the National Governors’ Association Proposal on Medicaid – Report

    Report

    Hearing before the United States House of Representatives Committee on Commerce on the National Governors Association Proposal on Medicaid Testimony of Diane Rowland, Sc.D., Executive Director, Kaiser Commission on the Future of Medicaid and Senior Vice President, Henry J. Kaiser Family Foundation March 6, 1996 Thank you, Mr. Chairman and members of the Committee, for this opportunity to provide some perspective on the recent proposal of the National Governors Association for Medicaid reform and its…

  • Talking With Kids About Tough Issues

    Report

    Talking With Kids About Tough Issues is a national campaign to support parents by Children Now and the Henry J. Kaiser Family Foundation. This guide for parents offers practical, concrete tips and techniques for talking easily and openly with young children ages 8 to 12 about tough issues: sex, HIV/AIDS, violence, drugs and alcohol. More about the campaign: Talk With Your Kids...before everyone else does

  • The Four Americas:  Government and Social Policy Through the Eyes of America’s Multi-racial and Multi-ethnic Society

    Poll Finding

    The Four Americas: Government and Social Policy Through the Eyes of America's Multi-racial and Multi-ethnic Society This report is the first of a series of surveys conducted jointly by The Washington Post/Kaiser Family Foundation/Harvard University examining public knowledge, values and beliefs on major issues and challenges facing our nation, such as race, poverty, reducing the deficit, the role of government in our society, and our nation's obligations in the world. The hope is that this…

  • The Impact of the “Medigrant” Plan on the Federal Payments to States

    Report

    The Impact of the "Medigrant" Plan on the Federal Payments to States The analysis examines the conference agreement plan for the redistribution of federal funds under a block grant for the Medicaid program. It also discusses the implications of the reductions in federal spending for beneficiary coverage. Report: The Impact Of The "Medigrant" Plan On Federal Payments To States                          

  • Medicaid and the Elderly

    Other Post

    Long-Term Care Spending In 1993, Medicaid spent $25.5 billion for long-term care services for elderly beneficiaries (Figure 5). This represents 58 percent of the $44 billion Medicaid spent on long-term care services for all population groups. The majority of spending was for care delivered in nursing facilities (84 percent) and ICFs-MR (2 percent). The remaining 14 percent of Medicaid long-term care spending went towards community-based care, including 3 percent for mental health services and 11…

  • Medicaid and the Elderly – Policy Brief

    Issue Brief

    Medicaid and the Elderly September 1995 Medicaid is a crucial health financing program for the elderly population, providing assistance to over 1 in 10 Americans age 65 or older. Nearly four million elderly people receive Medicaid assistance with medical and long-term care expenses. Medicaid's coverage helps low-income elderly people gain access to health care services, eases financial burdens for medical expenses, and provides a safety net for long-term care coverage. Medicaid plays three essential roles…

  • The California Single-Payer Debate, The Defeat of Proposition 186

    Report

    A report summarizing the campaigns of proponents and opponents to the California Health Security Act (Proposition 186) of 1994. The report includes findings from research commissioned by the Kaiser Family Foundation on the potential financial and administrative impact of the Act on California, as well as an analysis of the paid media campaigns on the issue (see also #1026, Statewide Surveys of Californians on Public Attitudes Toward the Single Payer Ballot Initiatives (Proposition 186), #1027,…