Medicaid

new and noteworthy

Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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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  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…

  • Both Expansion and Non-Expansion States Have Implemented Modernized Medicaid Systems to Streamline Enrollment under the ACA

    News Release

    Under the Affordable Care Act, Medicaid expansion and non-expansion states alike have implemented streamlined Medicaid enrollment systems that facilitate real-time eligibility determinations and automated renewals, according to a new 50-state survey from the Kaiser Family Foundation. Before the ACA, individuals could not apply for Medicaid by phone or online in many states. They typically had to provide paper documentation like pay stubs and wait weeks for an eligibility determination – and do it all over…

  • Community Health Centers Have Seen an Increase in the Share of Patients with Opioid Addiction

    News Release

    A majority of community health centers have seen a rising number of patients with opioid addiction over the last three years, according to a new issue brief released by the Kaiser Family Foundation. Nearly seven in 10 (69%) health centers reported an increase in patients with an addiction to prescription opioids and a similar share (63%) reported an increase in patients with an addiction to nonprescription opioids such as heroin and fentanyl. The findings of…

  • Medicaid in an Era of Health & Delivery System Reform: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2014 and 2015

    Report

    This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 14th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented…

  • Challenges for the Next Obamacare Open Enrollment

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman pinpoints the Affordable Care Act’s five biggest challenges heading into the second open enrollment period.

  • Ask KFF: MaryBeth Musumeci Answers 3 Questions on Kentucky, Arkansas Medicaid Work and Reporting Requirement Cases

    Issue Brief

    A federal district court has set aside the HHS Secretary’s approval of Medicaid waivers with work and reporting requirements and other eligibility and enrollment restrictions in Kentucky and Arkansas. For context as this all develops, we asked MaryBeth Musumeci, Associate Director at the Program on Medicaid and the Uninsured, three questions about the implications of the decisions.

  • Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs, 2014-2017

    Issue Brief

    Although the outpatient drug benefit accounts for only 6% of total Medicaid spending, drug spending has increased by double digits in recent years, and is expected to grow faster than most other Medicaid services in the next 10 years. This issue brief examines drug spending and utilization from 2014 through 2017 by drug group, brand and generic status, and biologic status to understand the causes for this increase in spending.

  • Re-approval of Kentucky Medicaid Demonstration Waiver

    Issue Brief

    On January 12, 2018, the Centers for Medicare and Medicaid Services (CMS) approved a Section 1115 demonstration waiver in Kentucky, entitled “Kentucky Helping to Engage and Achieve Long Term Health” or KY HEALTH. On the same day that CMS approved Kentucky’s waiver, Governor Bevin issued an executive order directing the state to terminate the Medicaid expansion if a court decides that one or more of the waiver provisions are illegal and cannot be implemented. This…

  • Conversation on Health Care and the 2018 Midterm Elections

    Event Date:
    Event

    Health care ranks among the top issues voters want to hear candidates talk about on the campaign trail, with costs being the most concerning health issue for voters. Meanwhile, the constitutionality of the Affordable Care Act (ACA) continues to be challenged in the judicial system with the latest case potentially jeopardizing the law’s protections for people with pre-existing conditions. And in four states, ACA Medicaid expansion initiatives are on the ballot to newly expand or…