Medicaid

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Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid Work Requirements

Tracking 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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • COVID-19 Vaccination Rates Among Nursing Home Staff Have Risen by 25 Percentage Points Since the Biden Administration Announced a Vaccination Mandate for Health Care Workers Last Year

    News Release

    In a new analysis, KFF researchers find that COVID-19 vaccination rates among nursing home staff increased by 25 percentage points nationally (63% to 88%) from when the Biden administration announced the vaccine mandate for health care workers in August 2021 to after vaccination deadlines passed in March 2022.

  • Nursing Facility Staff Vaccinations, Boosters, and Shortages After Vaccination Deadlines Passed

    Issue Brief

    This analysis uses nursing facility-level data reported by the federal government to track the increase in vaccination rates among nursing facility staff nationally and by state between August 2021 (when the vaccine mandate was first announced) and March 27th, 2022 (after the vaccine deadline for health workers had passed in all states). Additionally, this analysis provides state-level information on booster rates among nursing home staff and the prevalence of staffing shortages after all vaccination deadlines had passed.

  • State Actions to Address Nursing Home Staffing During COVID-19

    Issue Brief

    This issue brief summarizes federal and state standards related to nursing home staffing prior to COVID-19 and builds on existing information by identifying changes to state minimum staffing requirements adopted since the onset of the COVID-19 pandemic. We also examine state legislative and regulatory actions since the onset of the pandemic that directly affect worker wages and training requirements.

  • Unwinding the PHE: What We Can Learn From Pre-Pandemic Enrollment Patterns

    Issue Brief

    This brief examines typical enrollment patterns for Medicaid and CHIP and uses 2018 Medicaid claims data to gain insight into the effects of the continuous enrollment requirements by eligibility group. Roughly 2% of Medicaid enrollees come on or leave the program in an average month, although there is variation across eligibility groups. A policy to require continuous enrollment would result in sharp reductions in monthly disenrollment rates and would also reduce monthly enrollment rates due to reductions in churn.

  • An Overview of Medicaid Work Requirements: What Happened Under the Trump and Biden Administrations?

    Issue Brief

    The Trump Administration aimed to reshape the Medicaid program by newly approving Section 1115 demonstration waivers that imposed work and reporting requirements as a condition of Medicaid eligibility. However, courts struck down many of these approvals and the Supreme Court recently dismissed pending challenges in these cases. Available implementation data suggests that work requirements were confusing to enrollees and result in substantial coverage loss, including among eligible individuals.

  • Medicaid Administrative Data: Challenges with Race, Ethnicity, and Other Demographic Variables

    Issue Brief

    There are persistent disparities in health and health care for people of color, which reflect structural and systemic inequities rooted in racism and discrimination. High-quality comprehensive data are key to enabling policymakers, community leaders, and other key stakeholders to identify and address these inequities and measure progress over time. Medicaid/CHIP administrative data, also known as Transformed Medicaid Statistical Information System (T-MSIS) or TAF (T-MSIS Analytic File), hold the potential to inform disparities research through detailed demographic, service utilization, and spending data of Medicaid and CHIP beneficiaries —but there are current limitations.