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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.

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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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  • 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

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    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,…

  • Medicaid and Managed Care – Policy Brief

    Issue Brief

    Medicaid and Managed Care June 1995 This year, Medicaid will finance health and long-term care services to more than 35 million low-income Americans. In its role as a purchaser of health services for low-income families, Medicaid increasingly relies on managed care to deliver care. Almost 8 million Medicaid beneficiaries, predominately poor children and their parents, now receive health care services through a broad array of managed care arrangements, including Health Maintenance Organizations (HMOs) and less…

  • Managed Care and Low-Income Populations: A Case Study of Managed Care in Tennessee

    Report

    TennCare represents one of the most ambitious state-level efforts to restructure Medicaid and expand insurance coverage to the uninsured. The case study shows that the rapid change caused considerable confusion for patients, providers, and health plans. The TennCare experience provides early insights into the issues that states will face as they move to enroll more of their low-income populations into managed care arrangements.

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

    Report

    To gather early insights and timely information for state and federal policymakers concerning how the movement to managed care is affecting the poor and their access to care, the Henry J. Kaiser Family Foundation and The Commonwealth Fund are jointly sponsoring case studies and population surveys in California, Minnesota, New York, Oregon, and Tennessee. This case study describes the first year's experience of Oregon's Initiative, the Oregon Health Plan (OHP). It is designed to furnish…

  • National Survey of Public Knowledge of Welfare Reform and the Federal Budget

    Poll Finding

    Survey Shows "Two Faces" Of Public Opinion On Welfare Reform Americans Support Time Limits and Tough Work Requirements, But Reluctant to Abandon Those In Need Public Defines Welfare Broadly Understands Key Details of Welfare Programs Embargoed for release: 9:00 a.m. EST, Thursday, January 12, 1995 For further information contact: Matt James or Tina Hoff Menlo Park, CA -- A new Kaiser/Harvard survey of Americans nationwide has found that the public supports strong welfare reform measures,…

  • Statewide Surveys of Californians on Public Attitudes Toward the Single Payer Ballot Initiatives (Proposition 186)

    Other Post

    California Election Night Survey On Ballot Initiatives Anti-government Mood Defeats Proposition 186 A Perception That Undocumented Persons Use Costly Services Drives Vote For Proposition 187 Embargoed for release: 12:00 p.m. EST, Tuesday, November 15, 1994 For more information contact: Matt James or Tina Hoff Menlo Park, CA -- A Kaiser/Harvard survey of Californians in the 1994 election has found that the principal reason voters rejected Proposition 186, the state single payer initiative, was their concern…