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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.

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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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  • The Public’s Health Care Agenda for the New Congress and Presidential Campaign, December 2006

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    This Kaiser Family Foundation/Harvard School of Public Health National Survey looks at the public's priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It focuses, in particular, on differences and similarities among Democrats, Republicans, and those who identify themselves as Independents or something else. The poll, conducted November 9-19, 2006, by the Kaiser Family Foundation and the Harvard…

  • Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States

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    Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States Medicaid consumer direction of personal assistance services (CD-PAS) is a growing trend. Although overall enrollment in these programs is small, 42 states offered consumer direction in Medicaid in 2006. These programs allow Medicaid beneficiaries control over hiring, scheduling, training and paying of personal care attendants. This report is based focus groups with enrollees in CD-PAS programs in the four states…

  • Medicaid in a Declining Economy:  Limited Approaches for States to Control Spending

    Issue Brief

    Medicaid in a Declining Economy: Limited Approaches for States to Control Spending This brief analyzes results from its annual 50-state budget surveys of Medicaid directors from 2003 to 2007. The historical results describe how states adopted a wide array of Medicaid cost containment strategies during the last economic downturn and were assisted by the federal government to avoid deeper Medicaid cuts. Issue Brief (.pdf) See related material on this issue

  • Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year

    Report

    Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to expand access to community-based services and extend some services to a "moderate need" group for the first time to test the theory that early interventions…

  • Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

    Issue Brief

    This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.

  • From Crunch to Crisis: State Budgets, Medicaid and the Economy

    Event Date:
    Event

    Medicaid programs are feeling the strain as enrollment grows while state revenues come in lower than projected. How are Medicaid directors coping? How is the recession affecting low-income individuals and families? This briefing, cosponsored by the Alliance for Health Reform and the Kaiser Commission on Medicaid and the Uninsured, addressed these and related questions. For more information, please visit the Alliance's event page. Full Video   Speakers for this session: The panel is co-moderated by…

  • Physician Willingness and Resources to Serve More Medicaid Patients: Perspectives from Primary Care Physicians

    Issue Brief

    This issue brief attempts to assess how primary care physicians will respond to the entry of 32 million newly insured people into the health care system under health reform. The increase in the number of people with health coverage is expected to intensify competition among patients and payers for primary care resources. The brief analyzes data from a nationally representative survey of physicians to assess which adult-care primary care physicians are most likely to respond…