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Medicaid Work RequiremEnts

Tracking the 2025 Reconciliation Law’s Medicaid Work Requirements: Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

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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  • In 45 States, Fewer Than Half of Nursing Facilities Have Enough Staff to Meet New Federal Requirements

    News Release

    In 45 states, fewer than half of nursing facilities currently meet all three staffing minimums required in the final federal rule that the Centers for Medicare and Medicaid Services (CMS) released in April, and in 28 states, less than a quarter do, according to a new KFF analysis. The share of facilities that meet these requirements ranges from 5% or lower in four states (AR, TN, TX and LA) to 50% or higher in five…

  • The Connection Between Social Security Disability Benefits and Health Coverage Through Medicaid and Medicare

    Issue Brief

    This analysis examines who was eligible for Medicare and/or Medicaid between 2002 and 2022 because they received disability benefits from one of the country's Social Security disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Many who receive SSDI and SSI qualify for both Medicare and Medicaid, known as dual-eligible individuals.

  • Medicaid Waiver Priorities Under the Trump and Biden-Harris Administrations

    Issue Brief

    Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” As with broader Medicaid policy, the future landscape of Section 1115 waivers depends on the outcome of the November 2024 presidential election as a new administration could focus on different priorities, rescind existing guidance, or withdraw…

  • Medicaid Coverage of and Spending on GLP-1s

    Issue Brief

    This brief discusses the current landscape of Medicaid GLP-1 coverage and examines recent trends in Medicaid prescriptions and gross spending on GLP-1s.

  • Medicaid and Upcoming State Budget Debates

    Issue Brief

    This brief describes current state fiscal conditions as states begin fiscal year 2027 budget debates and highlights key areas to watch for Medicaid policy changes as states respond to fiscal challenges and the 2025 reconciliation law.

  • State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2020 and 2021

    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 20th 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 focuses on Medicaid policy changes planned for FY 2021, particularly those related to the COVID-19 pandemic.

  • Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19

    Issue Brief

    States used a number of Medicaid emergency authorities to address the COVID-19 public health emergency. Between March 2020 and July 2021 we tracked details on Medicaid Disaster Relief State Plan Amendments (SPAs), other Medicaid and CHIP SPAs, and other state-reported administrative actions; Section 1115 Waivers; Section 1135 Waivers; and 1915 (c) Waiver Appendix K strategies. This resource was last updated July 1, 2021 and is no longer being updated.