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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.

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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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  • Medicaid Section 1115 Waivers: Current Issues

    Fact Sheet

    This fact sheet provides a brief introduction to Section 1115 waivers in the Medicaid program and highlights policy issues related to recent waiver activity. Fact Sheet (.pdf)

  • Resources Related to Health Coverage and Hurricane Katrina

    Fact Sheet

    Health Care and Hurricane Katrina As part of the Kaiser Family Foundation's commitment to help respond to the devastation from Hurricane Katrina, you will find resources related to an ongoing effort to monitor and study the health coverage and needs of the victims. Check back frequently in the coming months for the latest updates. Recent Resources Testimony—Health Care In New Orleans: Progress and Remaining Challenges New Orleans Three Years After the Storm: The Second Kaiser…

  • State Perspectives on Medicaid Long-term Care: Report from a July 2003 State Forum

    Report

    This report summarizes discussions on Medicaid and long-term care at a forum with state officials held by the Kaiser Commission on Medicaid and the Uninsured in July of 2003. The forum, conducted by the National Academy of State Health Policy, addressed issues including Medicaid's role in long-term care, state fiscal crises and cost-containment strategies, and how state long-term care programs are evolving. Report (.pdf)

  • Serving Low-Income Families Through Premium Assistance: A Look At Recent State Activity

    Issue Brief

    This issue paper examines the policies in the HIFA waiver initiative that provide incentives for states to use Medicaid/SCHIP funds to assist in the purchase of private insurance options. It also reports on how states have responded to these new policies and what key policy questions are raised about premium assistance programs. Issue Paper (.pdf)

  • Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance

    Issue Brief

    Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act (DRA) of 2005 tightened Medicaid eligibility rules related to asset transfers. About 43 percent of all nursing home residents eventually become Medicaid eligible. This brief concludes that for people becoming Medicaid eligible at the time of nursing home admission, 50 percent had…

  • Citizenship Documentation Requirements in The Deficit Reduction Act Of 2005:  Lessons From New York

    Report

    Citizenship Documentation Requirements in The Deficit Reduction Act Of 2005: Lessons From New York New York State is one of only four states in the nation that already requires documentation of citizenship for Medicaid applicants (the others are Georgia, Montana and New Hampshire), and the only state with significant implementation experience. New York’s citizenship documentation requirement has been in place since the mid-1970s, and provides a solid base of experience that can inform the implementation…

  • Section 1115 Waiver Watch: A Look at the Use of Contingency Management to Address Stimulant Use Disorder

    Policy Watch

    Contingency management is an evidence-based psychosocial intervention that uses motivational incentives, such as vouchers or gift cards, to encourage recovery behaviors like stimulant abstinence and treatment session (e.g., cognitive behavioral therapy, group therapy) attendance. The Biden administration has approved five state contingency management waivers (California, Delaware, Hawaii, Montana, and Washington); two additional state contingency management requests are currently pending federal review.