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

Event Date:

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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  • Issues for Medicare Beneficiaries in Long-Term Care Facilities: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Vicki Gottlich, J.D., of the Center for Medicare Advocacy, looks at issues related to the new Medicare prescription drug benefit for people with Medicare who live in nursing homes or other long-term-care settings. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Who Are Direct Care Workers and How Might Federal Policy Changes Impact the Workforce?

    Issue Brief

    This analysis uses the 2024 American Community Survey (ACS) to provide an overview of demographic and socioeconomic characteristics of the direct care workforce, including home health aides, personal care aides, and nursing assistants who work in nursing facilities, residential care facilities, home health, and settings that provide nonresidential services for older adults and younger adults with disabilities.

  • Medicaid Health Homes: A Profile of Newer Programs

    Issue Brief

    Under the ACA, states have a new Medicaid option to establish "health homes" designed to improve care coordination and integration and reduce costs for beneficiaries with chronic conditions. Thus far, 15 states have implemented health home programs. Following on a 2012 brief profiling Medicaid health home programs in the first six states to adopt the option, this brief describes the health home programs in the nine states that have implemented them since that time, and…

  • Medicaid Financing Cliff: Implications for the Health Care Systems in Puerto Rico and USVI

    Issue Brief

    This brief provides an overview of the status of the health care systems and Medicaid programs in Puerto Rico and the U.S. Virgin Islands (USVI) about one and a half years after Hurricanes Irma and Maria struck the islands in September 2017. The hurricanes exacerbated the territories’ existing economic and health care challenges by accelerating outmigration of residents and health care providers and destroying homes, schools, health care facilities, and other infrastructure. After the storms,…

  • An Overview of State Approaches to Adopting the Medicaid Expansion

    Issue Brief

    State approaches to adopting the Affordable Care Act’s Medicaid expansion have varied greatly by state based on state law, the political context, or other factors. While it does not cover how every state has enacted the Medicaid expansion, this issue brief highlights some of the different approaches states have taken to adopt the Medicaid expansion. Each state’s circumstances are unique, and the actions taken by one state may not apply to another state’s circumstances.

  • Medicaid Expansion Briefing: What’s at Stake for States?

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation present a November 30 briefing to discuss the Medicaid expansion and what's at stake for states. Speakers address questions around the potential financial impact of the expansion on states, the role of the federal government in financing the expansion, and what it might mean for providers on the ground level, as well as the effect on the safety net population should states choose to opt…

  • Money Follows the Person: A 2012 Survey of Transitions, Services and Costs

    Issue Brief

    The Affordable Care Act extended the Money Follows the Person (MFP) demonstration grant program through 2016, giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. A total of 45 states…

  • Medicaid Enrollment: June 2011 Data Snapshot

    Issue Brief

    This snapshot finds that between June 2010 and June 2011, while enrollment continued to grow as an additional 2.2 million people enrolled in Medicaid programs nationally, enrollment growth in the program slowed as the economy started to improve. Enrollment growth over this period was 4.4 percent, down significantly each of the two prior annual periods. Since June 2007, just before the start of the recession, Medicaid enrollment has grown by over 10 million people, over…

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy…