Medicaid

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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 Work Requirements

Tracking Medicaid Work Requirements: u003cbru003eData 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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  • Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

    Issue Brief

    To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…

  • Oral Health in the U.S.: Key Facts

    Fact Sheet

    This fact sheet provides data on oral health care coverage and access for children, nonelderly adults and Medicaid beneficiaries, including state-by-state data on measures such as the share of adults who have had a dental visit within the past year. Fact Sheet (.pdf)

  • Medicaid Spending Growth over the Last Decade and the Great Recession, 2000-2009

    Report

    This report examines Medicaid spending growth nationally during the last decade, with a focus on growth during the recession of 2007 to 2009. The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been…

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…

  • Alternatives for Financing Medicaid Expansions in Health Reform

    Report

    Expanding Medicaid to cover low-income populations has been a fundamental component of leading health reform proposals. The House Leadership Bill would expand Medicaid to 150 percent of the federal poverty level and the Senate Leadership Bill would expand Medicaid to 133 percent of the federal poverty level. In both scenarios the federal government would finance a substantial share of costs for the expansion groups.  This analysis, however, shows that it is possible to distribute increased…

  • Managed Care and Low-Income Populations: A Case Study Of Managed Care In Florida

    Report

    This study is part of a larger initiative, the Kaiser/Commonwealth Low-Income Coverage and Access project funded by both the Henry J. Kaiser Family Foundation and The Commonwealth Fund, to gauge the impact of health restructuring on access and health insurance coverage for low-income populations in seven states through surveys, focus groups and case studies. The aim of the studies is to provide early insights and timely analyses that will assist other states and other efforts…

  • Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues

    Report

    Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues While private long-term care insurance (LTCI) has been available since the mid-1970s, its popularity has grown rapidly in recent years, and Congress is considering proposals that would further encourage LTCI purchase through expanded tax subsidies. Yet there has been little research on how well LTCI works and how much security it really provides. This report focuses on consumer protections for individuals buying LTCI in…

  • The Arizona Health Care Cost Containment System: Thirteen Years of Managed Care in Medicaid

    Other Post

    This report provides an overview of the Arizona Medicaid experience and contains valuable insights into the evolution and experience of a mandatory statewide Medicaid managed care program covering both acute care and long-term care services. Note: This publication is no longer in circulation. However, a copy may still exist in the Foundation's internal library that could be reproduced. Please email order@kff.org if you would like to pursue this option.

  • Getting the Most Bang for Our Health Reform Buck: Enrolling and Retaining Everyone Who’s Eligible

    Event Date:
    Event

    As Congress looks for ways to increase access to health care, existing programs such as Medicaid and the Children's Health Insurance Program are often overlooked. Yet enrolling those who are eligible for such programs is one of the easiest ways to expand coverage. This briefing, co-sponsored by Alliance for Health Reform and the Pharmaceutical Research and Manufacturers of America (PhRMA), looked at ways to streamline recruitment and enrollment, while exploring how expanding Medicaid and CHIP…

  • 2002 State and National Medicaid Spending Data

    Report

    (CMS-64) This set of tables, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, presents the most current state-by-state information on Medicaid spending by services using data from the Centers on Medicaid and Medicare Services (CMS) Form 64 for Federal Fiscal Year (FFY) 2002. CMS-64 data provide a somewhat different measure of spending than does the Medicaid Statistical Information System (MSIS). Please refer to the "Overview of Differences" document below…