Medicaid

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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.

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.

Dual Eligibles

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  • A Look at Substance Use and Mental Health Treatment Facilities Across the U.S.

    Issue Brief

    This brief uses 2022 data from the National Substance Use and Mental Health Services Survey (N-SUMHSS), an annual survey sent to all substance use and mental health treatment facilities to assess the supply and characteristics of these facilities at a national and state level. Despite the escalation of mental health needs and the increasing and evolving opioid epidemic, accessing treatment continues to be difficult--as indicated by consumer surveys and national data. Factors like the decline…

  • How Does Use of Medicaid Wraparound Services by Dual-Eligible Individuals Vary by Service, State, and Enrollees’ Demographics?

    Issue Brief

    This issue brief describes the share of dual-eligible individuals with full Medicaid benefits who use wraparound services, including institutional LTSS, home- and community-based services (HCBS), vision services, dental care, and non-emergency medical transportation (NEMT); and how use of these services varies by state and select demographic characteristics of enrollees.

  • Halfway Through the Medicaid Unwinding, About 16 Million Enrollees Have Been Dropped

    News Release

    Ten months into the unwinding of the Medicaid continuous enrollment provision, states have reported renewal outcomes for half of all enrollees whose eligibility needs to be reviewed during the unwinding period, including 34% (32.1 million) who have had their coverage renewed, and 17% (16.2 million) who have been disenrolled, according to KFF’s latest analysis of state-level data. There are reasons to expect disenrollment rates to moderate in the second half of the unwinding as states…

  • Medicaid: What to Watch in 2024

    Issue Brief

    As the start of 2024, many issues are at play that will affect Medicaid coverage, financing, and access. This issue brief provides context for these Medicaid issues and highlights key issues to watch in the year ahead.

  • Halfway Through the Medicaid Unwinding: What Do the Data Show?

    Policy Watch

    Ten months into the unwinding of the Medicaid continuous enrollment provision, KFF tracking shows that states have reported outcomes for roughly half of the people expected to undergo renewals during the unwinding period. This policy watch examines the latest data and key issues to watch during the next phase of the unwinding.

  • Medicaid Authorities and Options to Address Social Determinants of Health

    Issue Brief

    Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work and age. While there are limits, states can use Medicaid – which, by design, serves a primarily low-income population with greater social needs – to address social determinants of health. This brief outlines the range of Medicaid authorities and flexibilities that can be used to add benefits and design programs to address the social determinants of health.

  • Another Year of Record ACA Marketplace Signups, Driven in Part by Medicaid Unwinding and Enhanced Subsidies

    Policy Watch

    Open enrollment for the Affordable Care Act (ACA) Marketplaces is about to wrap up with another record high number of people signing up for coverage. Factors that contribute to this increase include unwinding of the Medicaid continuous enrollment, increased subsidies from the American Rescue Plan and Inflation Reduction Act, and increased marketing, outreach, and enrollment assistance.

  • Medicaid and State Financing: What to Watch in Upcoming State Budget Debates

    Issue Brief

    State legislatures are currently gathering to develop new budgets for state fiscal year (FY) 2025. Heading into this budget cycle, state fiscal conditions are shifting, with state revenues starting to decline following steep revenue growth during the pandemic. This issue brief examines trends in state fiscal conditions and discusses how state budgets and macroeconomic conditions may affect individuals and state Medicaid programs.

  • More Children are Losing Medicaid Coverage as Child Poverty Grows 

    News Release

    Children’s Medicaid and Children’s Health Insurance Program (CHIP) enrollment declined by 5.5%, or 2.3 million children, from March 2023, before the unwinding began, to September 2023, according to KFF’s latest analysis. Across all 50 states and DC, at least 14,377,000 people were disenrolled from Medicaid between April 1 and January 9, 2024. Medicaid eligibility levels are higher for children, raising concerns that they may be losing coverage and becoming uninsured despite remaining eligible. Medicaid covers…