Medicaid

new and noteworthy

An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

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: u003cbru003eData 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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  • 3 Key Questions About the Arkansas Medicaid Work and Reporting Requirements Case

    Issue Brief

    This issue brief answers three key questions about the implications of the appeals court’s decision setting aside the Health and Human Services (HHS) Secretary’s approval of a Section 1115 Medicaid waiver amendment that included work and reporting requirements and restriction of retroactive coverage in Arkansas.

  • A Conversation with Washington Gov. Inslee and Colorado Gov. Polis on the Public Option in Their States

    Event Date:
    Event

    On Friday, Feb. 7, KFF hosted a conversation with Colorado Gov. Jared Polis and Washington State Gov. Jay Inslee about their states’ efforts to establish a public health insurance option and make other changes to address health costs and access. The two governors have made health reforms a key part of their agendas and are seeking to expand access to affordable coverage for their residents through a public option – an approach that some national…

  • Implications of CMS’s New “Healthy Adult Opportunity” Demonstrations for Medicaid

    Issue Brief

    On January 30, 2020, the Centers for Medicare and Medicaid Services (CMS) released guidance inviting states to apply for new Section 1115 demonstrations known as the “Healthy Adult Opportunity” (HAO). These demonstrations would permit states “extensive flexibility” to use Medicaid funds to cover Affordable Care Act (ACA) expansion adults and other nonelderly adults covered at state option who do not qualify on the basis of disability, without being bound by many federal standards related to…

  • Key State Policy Choices About Medicaid Home and Community-Based Services

    Issue Brief

    State policy choices about Medicaid home and community-based services (HCBS) shape these benefits in important ways for the seniors and people with disabilities who rely on them to live independently in the community. This issue brief presents the latest data from the KFF's annual survey of Medicaid HCBS program policies in all 50 states and DC.

  • Medicaid Home and Community-Based Services Enrollment and Spending

    Issue Brief

    Medicaid continues to be the primary payer for home and community-based services (HCBS) that help seniors and people with cognitive, physical, and mental health disabilities and chronic illnesses with self-care and household activities. This issue brief presents Medicaid HCBS enrollment and spending data from KFF's annual state survey and includes tables with detailed state-level data.

  • Medicaid Work Requirements and People with HIV

    Issue Brief

    This data note examines the potential implications of work requirements for people with HIV, a population that relies heavily on Medicaid and for whom there are important clinical and public health reasons for maintaining consistent access to insurance coverage and HIV care.

  • What You Need to Know About the Medicaid Fiscal Accountability Rule (MFAR)

    Issue Brief

    On November 18, 2019, the Trump Administration released a proposed rule called the Medicaid Fiscal Accountability Regulation (MFAR). This brief provides some context on Medicaid financing, an overview of current state payment and financing rules, the provisions in the rule and potential implications for considerations.

  • Medicaid: What to Watch in 2020

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Key Medicaid issues to watch in 2020 include: Medicaid expansion developments; Section 1115 waiver activity; enrollment and spending trends; benefits, payment and delivery system reforms, and the implications of the 2020 elections.