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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  • COVID-19 Deaths and Cases in Long-Term Care Facilities Have Fallen to All-Time Lows in the Four Months Since Vaccinations Began

    News Release

    COVID-19 deaths and cases among residents and staff of long-term care facilities have fallen dramatically since vaccinations began in December, with deaths declining by nearly 89 percent and cases declining by nearly 92 percent as of April 2021, according to a new KFF analysis. COVID-19 deaths in long-term care settings fell from 1.7 deaths per 100,000 state residents in December to just 0.2 deaths per 100,000 state residents in April, an all-time low, the analysis…

  • Potential Implications of Policy Changes in Medicaid Drug Purchasing

    Issue Brief

    This brief examines how leading federal and state policy options related to changes in Medicaid Drug Rebate Program (MDRP), drug pricing, and payment and management of the Medicaid prescription drug would affect state and federal governments as well as private industry (including drug manufacturers, managed care organizations, and pharmacies).

  • Challenges in the U.S. Territories: COVID-19 and the Medicaid Financing Cliff

    Issue Brief

    More than a year into the public health emergency, the COVID-19 pandemic continues to impact the lives of Americans including those living in the U.S. territories. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health systems challenges for the territories. While additional federal funds have been provided over the statutory caps, these funds are set to expire at the end of September 2021. Without additional Congressional…

  • Medicaid Policy Approaches to Facilitating Access to Vaccines for Low-Income Children

    Policy Watch

    Following the recent US Food & Drug Administration’s (FDA) authorization and the Centers for Disease Control and Prevention’s (CDC) recommendation, children ages 5-11 are now eligible to receive Pfizer-BioNTech’s COVID-19 vaccine. There may be unique challenges to vaccinating young children, particularly those from low-income families who may face additional barriers to access. State Medicaid programs and Medicaid managed care plans are looking at a range of policy options to facilitate access to vaccines for young,…

  • State Actions to Address Nursing Home Staffing During COVID-19

    Issue Brief

    This issue brief summarizes federal and state standards related to nursing home staffing prior to COVID-19 and builds on existing information by identifying changes to state minimum staffing requirements adopted since the onset of the COVID-19 pandemic. We also examine state legislative and regulatory actions since the onset of the pandemic that directly affect worker wages and training requirements.

  • Key Characteristics of Infants and Implications of the Recent Formula Shortage

    Issue Brief

    In recent weeks, the United States has been grappling with a baby formula shortage following supply chain issues, a voluntary recall, and the closing of a plant that produces a large share of the country’s formula. Since it is recommended that infants receive breast milk or formula until they are age one, this shortage has had a significant impact across the country. Infants in low-income families and infants of color, who are often covered by…

  • Medicaid Enrollment Patterns During the Postpartum Year

    Issue Brief

    A provision in the American Rescue Plan Act (ARPA) of 2021 gives states a new option to extend Medicaid postpartum coverage to 12 months via a state plan amendment. This new option took effect on April 1, 2022 and is available to states for five years. Using Medicaid claims data from 2018, this brief examines enrollment patterns in the year following childbirth.