Medicaid

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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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 describes states’ current provider taxes and explores how rules governing provider taxes are changing.

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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  • Facing a Potential Funding Crunch, Community Health Centers in Medically Underserved Areas Around the Country Report They Are Considering Reductions in Staffing and Services That Would Limit Patients’ Access to Care

    News Release

    With a key source of federal funding set to expire in September, community health centers across the country are considering steps to reduce staffing, close some locations and eliminate or reduce services as they cope with uncertainty about their future financing, according to a new KFF/GWU survey and analysis.

  • Medicaid Family Planning Programs: Case Studies of Six States After ACA Implementation

    Report

    In light of the coverage trends and other ACA-related changes, this paper describes the impact on women and their partners, as well as family planning providers, of the impact of family planning expansion programs under Medicaid. It is based largely on interviews with state officials, providers and consumer advocates in Alabama, California, Connecticut, Illinois, Missouri and Virginia – a cross-section of states in terms of geography, Medicaid expansion status, and implementation of a Medicaid family…

  • 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.

  • Headed Back to School: A Look at the Ongoing Effects of COVID-19 on Children’s Health and Well-Being

    Issue Brief

    Emerging COVID-19 variants, like the Omicron subvariant BA.5 that has recently caused a surge in cases, may pose new risks to children and create challenges for the back-to-school season. Children may also continue to face challenges due to the ongoing health, economic, and social consequences of the pandemic. This brief examines how the COVID-19 pandemic continues to affect children’s physical and mental health, considers what the findings mean for the upcoming back-to-school season, and explores…

  • Mental Health Parity at a Crossroads

    News Release

    With federal agencies preparing to update parity regulations and Congress considering reforms, our new report explains existing parity requirements, including who they apply to and how their enforced, and highlights key policy issues raised by regulators and advocates that could be addressed in the future. Those issues include: Simplifying parity standards to make it easier for apples-to-apples comparisons between behavior health and medical benefits needed to assess compliance. Taking a closer look at how insurers are…

  • Medicaid and CHIP Eligibility and Enrollment Policies as of January 2022: Findings from a 50-State Survey

    Report

    The 20th annual survey of state Medicaid and CHIP program officials conducted by the Kaiser Family Foundation (KFF) and the Georgetown University Center for Children and Families in January 2022 presents a snapshot of actions states are taking to prepare for the lifting of the continuous enrollment requirement, as well as key state Medicaid eligibility, enrollment and renewal procedures in place during the PHE.

  • State Policies for Expanding Medicaid Coverage of Community Health Worker (CHW) Services

    Issue Brief

    Community Health Workers (CHWs) are frontline workers who have close relationships with the communities they serve, allowing them to better liaise and connect community members to health care systems. States may authorize Medicaid payment for certain CHW services under state plan or Section 1115 demonstration authority. States may allow or require managed care organizations (MCOs) to provide CHW services or include CHWs in care teams. Many states use CHW services to address the health needs…

  • With Government Funding Running Out, Americans Could Soon Face New Challenges in Accessing COVID-19 Treatments and Testing

    News Release

    A new KFF brief analyzes how the accessibility and cost of COVID-19 vaccines, treatments, and tests will change after the current government supply is depleted and the public health emergency ends. The Biden Administration has announced that it will have to end its purchase and distribution of COVID supplies as government funding is depleted. The public health emergency was recently extended for 90 additional days but is widely expected to end next year. These developments…