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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

Event Date:

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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  • State Awards From Most of the Rural Health Fund Could Vary Only Modestly Despite Large Differences in Rural Needs

    Issue Brief

    This brief provides estimates of how $37.5 billion of the $50 billion rural health fund could be distributed across states if all states are approved for funding. Awards from the $37.5 billion could range from an estimated $550 million (in Rhode Island) to just over $1 billion (in Texas) over five years if all states were approved for funding. These differences are relatively modest compared to the wide variation across states in rural health needs.

  • State Variations in the Role of the Reproductive Health Safety Net for Contraceptive Care Among Medicaid Enrollees

    Issue Brief

    This KFF analysis uses 2023 T-MSIS Research Identifiable Files to look at where reproductive-age female Medicaid enrollees received their last contraceptive visit by state. Overall, more than four in 10 (43%) female Medicaid enrollees received their last contraceptive visit of 2023 at a safety net provider, which includes Planned Parenthood clinics, community health centers, state and local health departments, and Indian health services, but there is wide variation by state.

  • How States Verify Citizenship and Immigration Status in Medicaid

    Issue Brief

    This brief describes federal citizenship and immigration status eligibility and eligibility verification requirements for Medicaid. Eligibility for federally-funded coverage under Medicaid and the Children’s Health Insurance Program is limited to U.S. citizens and certain lawfully present immigrants.

  • Health Policy 101 Introduction

    Feature

    Health Policy 101 is a comprehensive guide covering fundamental aspects of U.S. health policy and programs, including Medicare, Medicaid, the Affordable Care Act, employer-sponsored insurance, the uninsured population, health care costs and affordability, women's health issues, and health care politics. It includes overviews of private health insurance regulation, racial and ethnic disparities, public health, international comparison of health systems, U.S. global health policy, and the federal role in health policy. The chapters can be downloaded…

  • States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 21st annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights policies in place in state Medicaid programs in FY 2021, particularly those related to the…

  • Implementation Dates for 2025 Budget Reconciliation Law

    Feature

    This searchable timeline shows the implementation dates for the health care provisions included in the 2025 federal budget reconciliation law, previously known as "One Big Beautiful Bill Act." It includes provisions related to Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).

  • Map shows the percentage point increase in the uninsured population due to the budget reconciliation package based on CBO estimates, by state. An Additional 10M People Nationwide Could be Uninsured in 2034 Due to the Budget Reconciliation Law

    How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?

    Issue Brief

    This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10M in 2034 and rise to over 14M if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.

  • How Will States Implement Medicaid Work Requirements?

    Event Date:
    Event

    Four experts, including two state Medicaid directors, joined Health Wonk Shop series moderator Larry Levitt in an hour-long discussion of how states will go about implementing the new Medicaid work requirements.