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Work Requirements

Challenges with Implementing Work Requirements

Many states are anticipating a variety of implementation challenges, including the need for complex system changes, a compressed implementation timeline, and limited staff capacity.

What is the Medicaid Hardship Exception?

The number of Medicaid expansion enrollees who ultimately qualify for the high unemployment hardship exception will depend on how the exception is implemented and how unemployment rates changes.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies.

Medicaid Budget Survey

Medicaid Home Care

Using data from the 23rd KFF survey of officials administering Medicaid home care programs, 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.

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. The data come from KFF’s 23rd survey on Medicaid home care programs in all 50 states and DC.

KFF regularly surveys states about their Medicaid home- and community-based services (HCBS) programs and their eligibility policies for people who are eligible for Medicaid on the basis of having a disability or being 65 and older.

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This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.

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.

The Essentials

  • 5 Facts: Immigrants and Medicaid

    This brief provides five key facts on Medicaid and immigrants as context for understanding the potential impacts of policy changes under the Trump administration.

  • 5 Facts: Medicaid and Hospitals

    This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid, the share of births covered by the program, and how Medicaid expansion has impacted hospital finances.

  • Medicaid Financing: The Basics

    Medicaid is a major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.

  • 5 Facts: Medicaid’s Share of National Health Spending

    This brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • 5 Facts: Medicaid and Nursing Facilities

    The substantial Medicaid savings in the reconciliation bill could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them.

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  • Nursing Facility Staffing Shortages During the COVID-19 Pandemic

    Issue Brief

    This data note presents the most recent national and state-level data on nursing facility-reported staff shortages and describes the Biden Administration’s new policy initiatives to address staffing and other quality issues in nursing facilities.

  • Medicaid and CHIP Eligibility and Enrollment Policies as of January 2022: Findings from a 50-State Survey

    Report

    The 20th annual survey of state Medicaid and CHIP program officials conducted by the Kaiser Family Foundation (KFF) and the Georgetown University Center for Children and Families in January 2022 presents a snapshot of actions states are taking to prepare for the lifting of the continuous enrollment requirement, as well as key state Medicaid eligibility, enrollment and renewal procedures in place during the PHE.

  • State Policy Choices About Medicaid Home and Community-Based Services Amid the Pandemic

    Issue Brief

    This issue brief presents findings on key state policy choices about Medicaid HCBS in FY 2020. This is the latest data available, and the first since the onset of the COVID-19 pandemic. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC. A related brief presents the latest state-level data about the number of people receiving HCBS and HCBS spending

  • Community Health Centers Are A Key Source of COVID-19 Rapid At-Home Self-Tests For Hard-To-Reach Groups

    Policy Watch

    As part of an effort to promote equitable access to tests, the Biden administration launched a testing supply program that has set aside 25 million rapid at-home self-test kits for distribution by community health centers. Under the program, health centers will be distributing self-tests to patients and community members, with a focus on populations at greatest risk from adverse outcomes related to COVID-19.

  • Medicaid and At-Home COVID-19 Tests

    Policy Watch

    As COVID cases have surged across the United States due to the new Omicron variant, the Biden Administration has stepped up efforts to expand testing capacity including by making at-home COVID tests more available.

  • Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond

    Report

    Medicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can make health care difficult to afford. This report analyzes several policy options that could help make health care more affordable for people covered by Medicare, especially beneficiaries with relatively low incomes: adding an out-of-pocket limit to traditional Medicare, adding a hard out-of-pocket cap to Part D, expanding financial assistance through the Medicare Savings Programs, and expanding financial assistance through the Part D low-income subsidy program.