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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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  • Health Reform Opportunities: Improving Policy for Dual Eligibles

    Issue Brief

    As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare. Navigating two programs with different rules and financing incentives is complex for beneficiaries and providers, impedes efforts to improve care coordination and results in cost-shifting between programs that…

  • Medicaid Facts: Medicaid’s Role for Children – Fact Sheet

    Fact Sheet

    In 1995, 17.5 million children -- one-quarter of all children under age 18 -- had Medicaid coverage for health care services. Medicaid, the federal/state health program for the poor, pays for a broad range of services for children including well-child care, immunizations, prescription drugs, doctor visits, and hospitalization, and a range of long-term care services for children with disabilities. Medicaid plays a particularly strong role for low-income children, covering two-thirds (64%) of all poor children…

  • Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005

  • Consumers’ Experience in Massachusetts: Lessons For National Health Reform

    Report

    This report examines the impact of state health reform efforts on the lives of ordinary people in Massachusetts, including a look at coverage provided by both public programs and private sources. It focuses specifically on people's ability to afford and obtain needed care. Report (.pdf)

  • Children’s Health Coverage: Medicaid, CHIP, and Next Steps

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this briefing to examine the factors which influence children's coverage. Questions addressed include:What are the trends in private sector coverage? How well are the enrollment simplification and outreach tools that are included in this year’s CHIP reauthorization helping to reach those children who are eligible but unenrolled? How much does a child’s coverage depend on where he or she lives? For more information,…

  • Next Steps in Covering Uninsured Children: Findings from the Kaiser Survey of Children’s Health Coverage

    Issue Brief

    This issue brief provides key findings from the Kaiser Survey of Children's Health Coverage, including that many low- and middle-income working families with an uninsured child do not have access to employer-sponsored health insurance. The telephone survey of parents that was conducted in 2007 to learn more about children’s access to coverage and care and the health care cost-related pressures facing their families. Issue Brief (.pdf)

  • Children and Health Care Reform: Assuring Coverage That Meets Their Health Care Needs

    Issue Brief

    This issue brief examines the health care needs and health costs of children and analyzes the specific health care needs of two children in particular, including one with serious health challenges. The findings have implications for the health reform debate as policymakers consider minimum standards for coverage, required cost sharing amounts and limits on covered benefits in health plans. Issue Brief (.pdf)

  • Medicare Prescription Drug Improvement and Modernization Act Implementation Timeline: June 2004 – December 2006 Key Dates

    Report

    Key Implementation Dates for the Medicare Prescription Drug Benefit This timeline presents important dates and deadlines of key implementation activities related to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It runs from the beginning of 2005 through the end of 2006, the first year of the new Medicare drug benefit. Some of these dates are defined in the MMA statute, while others are from the final rule issued by the Centers…

  • The Latest Data on Mandatory and Optional Populations and Benefits in Medicaid

    Report

    With discussions on restructuring Medicaid occurring in state capitols and Washington, two new reports provide the latest data on how much of Medicaid's spending is for covering mandatory versus optional populations and services. The analysis shows that although optional populations account for 29 percent of Medicaid enrollment, 60 percent of all Medicaid spending (whether for mandatory or optional populations) is optional and 86 percent of optional spending is for the elderly or individuals with disabilities.…