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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.

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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  • Financing Health Coverage:  The Fiscal Relief Experience

    Issue Brief

    Financing Health Coverage: The Fiscal Relief Experience This paper provides an overview of the context which prompted federal fiscal relief to the states in 2003 and discusses the implications of this experiment in federal intervention for financing the Medicaid program. Policy Brief (.pdf)

  • New Reports Explain Medicaid’s Role in Long-Term Care and Track Trends

    Issue Brief

    With short and long-term policy changes to the Medicaid program being discussed, its role in providing long-term care is receiving closer examination. Medicaid is the single largest source of financing for long-term care, accounting for nearly half of all the nation’s spending for long-term care services, and demographic trends are likely to place additional pressure on Medicaid. New attention is being focused on who relies on Medicaid for help with nursing home bills and how…

  • Learning From History: Deinstitutionalization of People with Mental Illness As Precursor to Long-Term Care Reform

    Report

    This report examines what policy lessons can be learned from the deinstitutionalization of people with mental illnesses and applied to potential long-term care reform for the elderly or those with significant disabilities. The study assesses the reforms that took place under deinstitutionalization, their impact and what mistakes were made. It also discusses the take-away lessons for long-term care policy, with a focus on planning, financing, living situations and the role of families, workplace issues, and…

  • New Survey Indicates Medicaid Enrollment Declines For First Time In Nearly A Decade

    Event Date:
    Event

    The annual 50-state survey of state officials on Medicaid and state budget actions reports enrollment in Medicaid declined for the first time in nearly a decade. The 0.5 percent enrollment decline in fiscal year 2007 was driven primarily by two factors. States reported that the new citizenship documentation requirements were causing significant delays in processing applications, affecting mostly individuals already eligible for the program. State officials also cited the good economy and lower unemployment for…

  • Medicaid and Budget Reconciliation:  Implications of the Conference Report

    Issue Brief

    Medicaid and Budget Reconciliation: Implications of the Conference Report This issue brief provides an overview of the federal budget context and then highlights key Medicaid savings proposals in the budget reconciliation conference bill and discusses the implications of the proposed changes. Issue Brief (.pdf)

  • Resources on Medicaid Policy Changes in the Federal Budget Reconciliation Bill

    Issue Brief

    The Foundation's Kaiser Commission on Medicaid and the Uninsured has collected resources related to the Medicaid policy changes in the budget reconciliation law, Deficit Reduction Act of 2005. Deficit Reduction Act of 2005: Implications for Medicaid West Virginia Medicaid State Plan Amendment: Key Program Changes and Questions KYHealth Choices Medicaid Reform: Key Program Changes and Questions Reports Explore Long-Term Care Issues Included in the Deficit Reduction Act The Nuts and Bolts of Making Medicaid Policy…

  • New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility?

    Issue Brief

    A few recent state Medicaid initiatives have emerged that take the program into new directions. States have expressed a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and, in some cases, relying more heavily on the private marketplace. In addition, states have sought to shape their initiatives in ways that could help them better predict and limit their exposure to costs. This brief…

  • Medicaid’s Role in Long-Term Care: Q & A

    Fact Sheet

    Financing long-term care for the nearly 10 million Americans who need services and support to assist them in life’s daily activities continues to challenge the nation. While Medicaid is the nation’s major source of financing for long-term care services, paying for over 40% of total long-term care, its role is not well understood. Misperceptions on who qualifies and what is covered are common. A new question and answer fact sheet about Medicaid’s long-term care assistance…

  • The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions

    Fact Sheet

    The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions This fact sheet summarizes Vermont’s Section 1115 waiver to make fundamental changes to its Medicaid program that provides long-term services and supports to eligible, low-income state residents. The waiver was designed to increase access to home and community-based services (HCBS), reduce use of institutional services and control overall costs for long-term services spending. The state hopes to achieve these goals by limiting…