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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • 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…

  • Record ACA Marketplace Signups for 2024 Are Driven in Part by Medicaid Unwinding and More Affordable Coverage 

    News Release

    Enrollment in the Affordable Care Act (ACA) Marketplaces will hit another record high in 2024, with sign-ups to date topping 20 million—already 4 million above last year’s record high. The Medicaid unwinding, enhanced Marketplace subsidies that make coverage more affordable, as well as increased marketing, outreach, and enrollment assistance have all played a role in this growth, according to a new analysis from KFF. Marketplace sign-ups have nearly doubled since 2020. The Medicaid unwinding is…

  • With More than Half of Medicaid Enrollees Awaiting their Renewal Process, New Report Highlights Lessons Learned that Can Inform State Efforts and Reduce Disenrollments for “Procedural” Reasons

    News Release

    At the beginning of 2024, nine months into states’ efforts to unwind the Medicaid continuous enrollment provision and reverify enrollees’ eligibility, states have completed renewals for less than half of all enrollees. To gain a better understanding of what challenges states are facing and the effects of different unwinding strategies, KFF interviewed state Medicaid officials in Arizona, Indiana, and Pennsylvania, as well as others involved, including representatives from Medicaid, managed care plans, legal aid organizations,…

  • Unwinding of Medicaid Continuous Enrollment: Key Themes from the Field

    Issue Brief

    Data are important to help monitor how unwinding is going across states, but trackers and dashboards only tell part of the unwinding story. This brief examines the perspectives of state officials and others involved in the unwinding process. The brief provides information on outreach and engagement, renewal processes and coverage transitions, providing lessons for the ongoing unwinding process, as well as for how to conduct more effective Medicaid renewals generally in the future.

  • Working-Age Adults with Disabilities Living in the Community

    Issue Brief

    In September 2023, the National Institutes of Health designated people with disabilities as a population experiencing health disparities, which will help ensure that people with disabilities are represented in research funded by the National Institutes. Also in September of 2023, the Biden Administration proposed a new rule that would update the requirements for nondiscrimination on the basis of disability. Among other changes, the proposed rule would codify the Olmstead court decision, which requires people with…

  • What 2024 Could Bring for Working-Age Adults with Disabilities 

    News Release

    As the 25th anniversary of Olmstead nears, more than one-in-10 working age adults have a disability and most do not receive public disability income.  Over one-in-10 working-age adults reported having a disability in 2022. A disability is defined as having difficulty with hearing, vision, cognition, ambulation, self-care, or independent living, according to KFF's examination of data on people with disabilities from the American Community Survey. Fewer than a third of working-age adults with disabilities receive…