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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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  • New Reports Explore State Implementation of Prescription Drug Prior Authorization

    Other Post

    States are grappling with a fiscal crisis that threatens funding for Medicaid, the federal-state partnership that provides health coverage for low-income populations. Two new studies shed light on the impact of an increasingly popular strategy - prior authorization - being used to control prescription drug spending. In fiscal year 2003, some 21 states are planning to expand or create prior authorization systems where the state must provide pre-approval before selected drugs can be dispensed to…

  • Medicare-Medicaid Policy Interactions

    Issue Brief

    Because over seven million elderly and disabled individuals are entitled to benefits under both Medicare and Medicaid, policy changes in one program not only affect both coverage and spending in the other but also impact access to services by individuals eligible for both programs. This primer summarizes two key policy interactions and includes a quick reference table of the most significant linkages between the two programs. Issue Brief (.pdf)

  • Medicaid’s Federal-State Partnership: Alternatives for Improving Financial Integrity – Summary of Issues, Approaches, and Alternatives for Reform

    Report

    In this report from the Kaiser Commission on Medicaid and the Uninsured, Penny Thompson, former deputy director for the Center for Medicaid and State Operations, used existing models from the private sector and other government programs to assess Medicaid’s financial management and to develop options for improvement. This table summarizes the report’s findings. Chart (.pdf) Report

  • Managed Care For Low-Income Populations with Special Needs: The Tennessee Experience

    Report

    This paper provides a targeted review of Tennessee's experience providing health care to individuals with special needs under TennCare, its Medicaid managed care initiative. The first part reviews the experience of TennCare Partners, the behavioral health carve-out program created in 1996. The second part reviews how TennCare's structure affects the disabled and chronically ill.

  • States’ Concerns About the Medicare Drug Debate and the Fiscal Impact of Shifting the Cost of Dual Eligible Care

    Issue Brief

    As the U.S. Congress continues to search for an agreement on the form of a Medicare prescription drug benefit, the Commission has two new reports related to the debate. One new publication reports on findings from an October 26 discussion with state Medicaid officials on the implications of a Medicare drug benefit for states and dual eligibles. The other report provides state-level estimates on spending on dual eligibles and illustrates the effects of scenarios where…

  • Medicaid Mental Health and Substance Use: Expansion Trends and the Fiscal Pressure Ahead

    Issue Brief

    This brief examines recent state trends in Medicaid behavioral health coverage and payment and state coverage of select treatment models for people with serious mental illness—a population that has historically faced significant barriers to care. This includes details about coverage of Certified Community Behavioral Health Clinics (CCBHCs) (as a provider type), Assertive Community Treatment (ACT), and Coordinated Specialty Care for First Episode Psychosis (CSC-FEP).

  • Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries

    Issue Brief

    On May 22, the House passed a reconciliation bill, the One Big Beautiful Bill Act, which would partially pay to extend expiring tax cuts by cutting Medicaid. The Congressional Budget Office (CBO) estimates that the bill would reduce federal Medicaid spending by $793 billion over ten years and 10.3 million fewer people would be enrolled in Medicaid in 2034, including 1.3 million people with Medicare, otherwise known as “dual-eligible individuals”.

  • Medicaid Expansion is a Red and Blue State Issue

    Issue Brief

    With President-elect Trump returning to the White House and Republicans controlling Congress, significant changes to the Medicaid expansion are expected. This data note provides key facts on the Medicaid expansion, highlighting the financial and coverage impacts of any changes across states that voted for President-elect Trump and those that voted for Vice President Harris.