Medicaid

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Medicaid/CHIP Monthly Enrollment Tracker

Medicaid enrollment declined by 5 million people (6%) from May 2025 through May 2026. Child enrollment in Medicaid and CHIP declined in 49 states and DC, and adult enrollment dropped in all but five states (IA, MO, NC, OK, SD). KFF's tracker presents the most recent Medicaid enrollment data by month and state.

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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  • Medicaid Home and Community-Based Services Programs: 2013 Data Update

    Report

    This report summarizes the key national trends to emerge from the latest (2013) participant and expenditure data for the three main Medicaid HCBS programs: (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915 (c) HCBS waivers. It also highlights findings on 2015 eligibility, enrollment, and provider reimbursement policies.

  • The Cost of Not Expanding Medicaid

    Report

    As states wrap up legislative sessions and make decisions about whether to implement the Medicaid expansion included in the Affordable Care Act (ACA), this new analysis highlights the implications of these decisions for coverage, state budgets and providers. The decisions by as many as 27 states not to adopt the Medicaid expansion will leave a many more uninsured; these states would also forgo billions in federal funds.

  • New Analysis Summarizes Recent Research on the Effects of ACA Medicaid Expansion, Providing Context for Renewed Expansion Debates in States

    News Release

    New federal financial incentives for Medicaid expansion and the increased reliance on Medicaid as a coverage safety net during the pandemic have renewed debate in the 12 states that have not adopted the Medicaid expansion under the Affordable Care Act. A new KFF literature review provides context for these expansion debates by summarizing evidence from nearly 200 studies about the effects of Medicaid expansion that were published between February 2020 and March 2021. These studies…

  • Community Health Centers in the U.S. Territories and the Freely Associated States

    Issue Brief

    The U.S territories and the Freely Associated States (FAS) have faced an array of longstanding fiscal and health challenges, made worse by recent natural disasters and the coronavirus pandemic. Community health centers are an important part of health care system in the territories and FAS, providing access to a range of primary care services to low-income and vulnerable individuals. Based on findings from a survey of health centers, data from the Uniform Data System (UDS),…

  • 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.

  • Who Uses Medicaid Long-Term Services and Supports?

    Issue Brief

    This analysis examines the characteristics of Medicaid enrollees who use Medicaid long-term services and supports (LTSS), how enrollees who use LTSS differ from those who do not use these services, and how enrollees who use different types of LTSS differ from each other.

  • 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…

  • 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.

  • Over-the-Counter Oral Contraceptive Pills

    Issue Brief

    Oral contraceptives are the most commonly used method of reversible contraception in the U.S. In July 2023, the FDA approved Opill, the first daily oral contraceptive pill to become available over the counter (OTC) without a doctor’s prescription. This issue brief provides an overview of OTC oral contraceptives and laws and policies related to insurance coverage.