Medicaid

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.

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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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  • New KFF Focus Groups Reveal Medicaid Enrollee Experiences During Unwinding

    News Release

    Over six months after the expiration of pandemic-era enrollment protections, at least 27 million Medicaid enrollees—or roughly one-in-three enrollees across the country—have completed their state’s eligibility renewal process for the program. Over 18 million people have had their coverage renewed and over 10 million have been disenrolled, as of November 8, 2023. New KFF focus groups look beneath the numbers at the experiences of enrollees who have gone through the Medicaid renewal process. Drawing from…

  • 10 Million Have Been Disenrolled from Medicaid; Some Could Find Themselves Eligible for Marketplace Subsidies

    News Release

    More than 10 million people have been disenrolled from Medicaid, based on data available from 50 states and the District of Columbia as of November 1, 2023. Disenrollment rates range from 65% in Texas to 10% in Illinois, according to KFF’s ongoing tracking. Differences in state renewal policies and system capacity likely explain some of this variation. Some disenrolled individuals are regaining Medicaid coverage. As a result, overall declines in Medicaid enrollment will be less…

  • In Response to Home-Care Workforce Shortages, Most States Report Increasing Medicaid’s Payment Rates and Expanding Worker Opportunities

    News Release

    Almost every state reported increasing Medicaid payment rates for home- and community-based services to recruit and retain workers as part of their strategy to address long-standing workforce challenges, according to a new report from a survey of state officials administrating those programs. Most states also report developing or expanding worker education and training programs and offering incentive payments to recruit or retain workers. All surveyed states reported shortages of care workers and most (43 states)…

  • Six Months into the Medicaid Unwinding: What Do the Data Show and What Questions Remain?

    Policy Watch

    Six months into the unwinding of the Medicaid continuous enrollment provision, KFF tracking shows states are reporting outcomes for over 28 million renewals, accounting for three in ten people who were enrolled as of March 2023 when continuous enrollment ended. This policy watch examines the latest data and key questions as the unwinding continues to unfold.

  • Understanding Medicaid Ex Parte Renewals During the Unwinding

    Policy Watch

    As states unwind the Medicaid continuous enrollment provision, they must comply with federal renewal requirements, including the requirement to conduct ex parte, or automated renewals. This policy watch explains what ex parte renewals are, examines variation in ex parte renewal rates across states, and discusses current issues as well as actions states are taking to increase ex parte rates.

  • Consumer Problems with Prior Authorization: Evidence from KFF Survey

    Issue Brief

    This Data Note highlights findings from the KFF Consumer Survey on problems consumers have experienced with prior authorization requirements. Overall, those with Medicaid, those who are higher utilizers of care, and those who seek certain types of care such as care for a mental health condition or diabetes encountered more problems with prior authorization over the past year.

  • What Do Medicaid Unwinding Data by Race and Ethnicity Show?

    Policy Watch

    As of September 2023, nine states are reporting data that allow for analysis of disenrollment patterns by race and ethnicity. Five states (Arizona, California, Indiana, Minnesota, and Oregon) provide data on disenrollment rates by race and ethnicity. Four states (Nevada, Oklahoma, Virginia, and Washington) report the distribution of disenrollments by race and ethnicity that can be compared to the distribution of overall Medicaid enrollment in each state by race and ethnicity.