Medicaid

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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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  • Medicaid:  An Overview of Spending on “Mandatory” vs. “Optional” Populations and Services

    Issue Brief

    Medicaid: An Overview of Spending on "Mandatory" vs. "Optional" Populations and Services This issue brief provides an overview of Medicaid’s optional beneficiaries and services. The brief demonstrates that although “optional” populations account for only 29 percent of Medicaid enrollment, 60 percent of all Medicaid expenditures for both “mandatory” and “optional” populations are “optional,” and the majority of these (86 percent) pay for services provided to the elderly and disabled. Issue Paper (.pdf)

  • The California Medicaid Program at a Glance

    Fact Sheet

    This fact sheet provides an overview of California's Medicaid program, Medi-Cal, the population that it serves, and the services it covers. Fact Sheet (.pdf)

  • Who Stays and Who Goes Home: Using National Data on Nursing Home Discharges and Long-Stay Residents to Draw Implications for Nursing Home Transition Programs

    Report

    This report analyzes survey data to describe the characteristics of two groups of nursing home residents who are 65 years or older: those who are discharged back to the community over a one year time period and those who remain in nursing homes for 90 days or longer. Over the last several years, some states have turned their attention to returning nursing home residents to community settings through nursing home transition programs. The findings provide…

  • 2002 State and National Medicaid Enrollment and Spending Data (MSIS)

    Report

    This set of tables, prepared by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, presents state-by-state information on Medicaid enrollment, expenditures, and spending per enrollee for Federal Fiscal Year (FFY) 2002. These tables are based on analysis of data from the Medicaid Statistical Information System (MSIS) and provide a somewhat different measure of spending than CMS-64 data. Please see the "Overview of Differences" document below for more on the features of…

  • Medicaid Long-Term Services Reforms in the Deficit Reduction Act

    Issue Brief

    The Deficit Reduction Act of 2005 (DRA) was signed by the President in February 2006 and included major changes to the Medicaid program. This brief provides an overview of the changes to the rules and direction of Medicaid long-term care services as enacted in the DRA. Issue Brief (.pdf)

  • Outreach Strategies for Medicaid and SCHIP: An Overview of Effective Strategies and Activities

    Report

    Outreach Strategies for Medicaid and SCHIP: An Overview of Effective Strategies and Activities This paper highlights key components of effective outreach strategies to enroll children in Medicaid and SCHIP and also to get them access to care once enrolled. In addition, the paper examines how these strategies have been implemented in states and the challenges of continuing to push for enrollment as states face continued fiscal pressures and barriers to participation are resurrected. Report (.pdf)

  • Medicaid’s Home Care Support for Family Caregivers in 2025

    Issue Brief

    Medicaid home care programs offer various supports to family caregivers such as paid caregiving, self-directed services, respite care, and caregiver training. 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.

  • Payment Rates for Medicaid Home Care Ahead of the 2025 Reconciliation Law

    Issue Brief

    Increased payment rates for Medicaid home care workers are states’ key approach to addressing workforce shortages. 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.

  • New Trump Administration Proposals Would Further Limit Gender Affirming Care for Young People by Restricting Providers and Reducing Coverage

    Issue Brief

    This brief examines two proposed federal rules that would further restrict youth access to gender affirming care. One rule would change the hospital Conditions of Participation (CoPs) which would prohibit most Medicare and Medicaid enrolled hospitals from providing certain types of gender affirming medical care for young people and the other would prohibit federal Medicaid or CHIP funds from covering this care. The rules have a 60-day comment period, do no take immediate effect, and…