Medicaid

new and noteworthy

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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  • New Article and Infographics in JAMA Examine Medicaid and Medicare at 50 Years

    News Release

    The July 28 special issue of the Journal of the American Medical Association (JAMA) includes an article written by Kaiser Family Foundation President and CEO Drew Altman and former U.S. Senate Majority Leader William H. Frist, MD, and two infographics from the Foundation that examine the past, present, and future of Medicaid and Medicare.

  • Medicaid Coverage of Pregnancy and Perinatal Benefits: Results from a State Survey

    Report

    This report details findings from a state survey on perinatal benefits in place as of July 1, 2015 for women enrolled in fee-for-service Medicaid through different eligibility pathways, including traditional pre-ACA Medicaid pathways, expansion, and pregnancy-related eligibility for the following services: basic prenatal care, counseling and support services, delivery and postpartum care, and breastfeeding supports.

  • The Role of Medicaid in Rural America

    Issue Brief

    This brief describes Medicaid’s role for 52 million nonelderly children and adults living in the most rural areas in the United States and discusses how expansions or reductions in Medicaid could affect rural areas.

  • Restructuring Medicaid in the American Health Care Act: Five Key Considerations

    Issue Brief

    On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected under current law, and 14 million fewer people would be covered by Medicaid than expected under current law. This brief considers five key Medicaid implications of the House bill.

  • Views of Governors and Insurance Commissioners on ACA Repeal and Changes to Medicaid: Responses to a Congressional Request for State Input on Health Reform

    Issue Brief

    This brief summarizes responses from governors and insurance commissioners in 35 states, including DC, to a request from members in the House of Representatives for state input on health care reforms. These responses provide insight into state leaders’ views on repeal and replacement of the ACA and the changes Congress is considering making to the financing and structure of Medicaid. It finds that respondents have mixed views on the ACA and potential repeal and replacement of the ACA; most respondents expressed cautions or concerns about repeal, which are shared among both Republicans and Democrats and those who oppose and support appeal; more respondents expressed concerns about capped Medicaid financing than indicated support, and those that expressed support included significant caveats; less than half of respondents, mostly Republican, cited interest in increased state Medicaid flexibility; over half of respondents supported returning authority to states to regulate insurance markets; and few respondents expressed interest in allowing the sale of insurance across state lines, HSAs, or high risk pools.

  • Data Note: Variation in Per Enrollee Medicaid Spending Across States

    Issue Brief

    Proposals to transition Medicaid a block grant or per capita cap would reduce federal spending. To understand per capita cap proposals, it is helpful to understand variation in per enrollee spending and per enrollee spending growth across states and enrollment groups. A per capita cap policy could lock in historic variation. This data note uses interactive maps and tables to show variation in per enrollee spending and spending growth by state and eligibility group.

  • Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid

    Feature

    This month’s Kaiser Health Tracking Poll explores the public’s views on the changing landscape of the U.S. health care system including proposals to repeal and replace the Affordable Care Act (ACA) and to change Medicaid financing to a system of block grants or per capita allotments. The survey also examines which sources, including news media and other sources, the public trusts for information on the proposed changes to the country’s health care system.