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Medicaid work requirements

Tracking the 2025 Reconciliation Law’s 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.

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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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  • Section 1115 Waiver Watch: Medicaid Services for Traditional American Indian and Alaska Native Health Care Practices

    Issue Brief

    In October 2024, the Centers for Medicare and Medicaid Services (CMS) approved the first ever Section 1115 waiver demonstration amendments that would allow Medicaid and CHIP coverage of traditional health care practices for American Indian or Alaska Native (AIAN) people in Arizona, California, New Mexico, and Oregon. This Waiver Watch reviews disparities in health and health care for AIAN people and summarizes the key features of the approved waivers.

  • Pulling It Together: Are We Headed for a Government Takeover of Health Care?

    Perspective

    Remember the “government takeover of the health care system” argument that critics of the health reform law have used?  Well, last week the Office of the Actuary in the Centers for Medicare and Medicaid Services published the latest projections of health spending in the journal Health Affairs.  Attention focused mainly on the Actuary’s estimate that national health spending would grow to almost 20% of GDP by 2020 and that the Affordable Care Act (ACA) would…

  • The Nuts and Bolts of Making Medicaid Policy Changes: An Overview and a Look at the Deficit Reduction Act

    Issue Brief

    The Deficit Reduction Act of 2005 (DRA), signed into law on February 8, 2006, contains a large number of changes in Medicaid policy that are expected to affect almost all elements of the Medicaid program—eligibility, benefits and cost-sharing, provider payments and program integrity. In most instances the policy changes are optional for state Medicaid programs, but in some the changes are mandatory. At the federal level, the interpretation and implementation of these legislative policy changes…

  • Low-Income Adults in New Orleans in 2008: Who Are They and How Are They Faring?

    Poll Finding

    Based on data from Kaiser's Second Post-Katrina Survey, this Survey Brief profiles low-income adults in New Orleans in 2008, examining their demographics, personal recovery from the aftermath of Hurricane Katrina, worries and concerns, and financial and health care challenges. It finds that low-income adults in New Orleans are more likely than other adults in the city to still be dealing with recovery from the aftermath of Hurricane Katrina and facing financial and health care challenges.…

  • The Coverage and Cost Impacts of Expanding Medicaid

    Report

    This paper quantifies the impacts on coverage and cost of expanding Medicaid to cover more of the low-income uninsured, including adults, at various income levels and with improved participation rates. The analysis models two primary options to expand Medicaid (250% FPL for children, 100% FPL for adults; 300% FPL for children, 150% for adults) as well as the same options with no change for children. Report (.pdf)

  • Rising Health Pressures in an Economic Recession: A 360-Degree Look at Four Communities

    Report

    This report draws on interviews and focus groups in four communities to examine at the grassroots levels the experiences of families, employers, safety-net providers and community organizations in four U.S. communities hard hit by the recession. The communities are Beloit, Wisc.; Tampa-St. Petersburg, Fla.; Long Island, N.Y.; and Sonoma, Calif. The report explores the financial and personal struggles of families who have suffered economic reversals and lost health coverage, forcing many to juggle bills and…

  • Pulling It Together: Predictions

    Perspective

    I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS.  One reason for this is the lingering effect of the recession.  Employers will have little trouble attracting workers in the…