Medicaid

new and noteworthy

An Early Look at States’ Differing Approaches to Implementing Medicaid Work Requirements Amid Cost and Time Constraints and Uncertainty

A new KFF survey of state Medicaid officials and focus groups in eight states captures the different choices states are making about how to implement Medicaid work requirements, with seven states planning for a more restrictive approach to verifying work or exemption status or to implement work requirements early. These implementation plans are taking shape as states encounter time, cost, and other constraints as well as uncertainty about how to define and verify certain exemptions due to delayed federal guidance.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid Work Requirements

Tracking 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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

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.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

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.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage
  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.
  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.
  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.
  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.
  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Oral Histories: Report from a Dental Fair

    Video

    This video profiles patients attending a dental fair in rural Virginia and highlights the impact of lack of coverage for oral health services. Uninsured adults have vast oral care needs, and untreated dental problems can have serious health, employment and social consequences.

  • The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession

    Event Date:
    Event

    This annual 50-state survey finds that number of people on Medicaid and state spending on the program are climbing sharply as a result of the recession, straining state budgets and pressuring officials to curb costs despite increased financial help from the federal government through the American Recovery and Reinvestment Act (ARRA). The survey finds that these trends are expected to continue well into the 2010 fiscal year, with the slumping economy contributing to the loss…

  • Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts

    Issue Brief

    This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS). Among the key ideas drawn from a working group discussion at the Foundation are the benefits of: • providing additional federal financing to states to provide Medicaid HCBS and to administer these benefits; • simplifying the process for states…

  • Medicaid Expenditures Increased by 5.3% in 2007, Led By Acute Care Spending Growth

    Issue Brief

    This brief presents analysis of the latest available Medicaid spending and enrollment data to examine recent trends in program enrollment, total spending, spending by service, and spending per enrollee. The focus is on spending changes between 2006 and 2007, with historical context also provided. After Medicaid spending declined in 2006 for the first time in the program's history, spending climbed by 5.3 percent in 2007. In raw dollars, spending increased to $330.8 billion in 2007,…

  • Key Issues in Medicaid and Home and Community-Based Services and Support

    Issue Brief

    These briefs examine current issues in providing more people who need long-term care services and supports access to these Medicaid services in home and community-based settings rather than in institutional ones. The first brief, Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts , highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates…

  • Efforts in States to Promote Medicaid Community-Based Services and Supports

    Issue Brief

    This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states. Brief (.pdf)

  • Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage

    Issue Brief

    This issue brief examines the health care needs and health costs of individuals with special health challenges, focusing on those with low-to-moderate incomes. It finds that even under a benefit package more generous than most offered in the private insurance market, individuals and families can face significant gaps in coverage and large out-of-pocket costs, especially if they have serious health conditions. The findings have implications for the health reform debate as policymakers consider minimum standards…

  • Matching Health Benefit Packages to Health Needs: Key Issues To Consider In Health Reform

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    Event

    Three reports and a video collectively examine the range of health care needs and costs that people face today against the backdrop of the scope of health coverage that may be available to them under health reform. Children and Health Care Reform: Assuring Coverage That Meets Their Health Care Needs and Individuals With Special Needs and Health Reform: Adequacy of Health Insurance Coverage examine the needs of children and adults, respectively, focusing on those with…

  • Health Reform: Lessons From Massachusetts

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    Event

    As Congress debates comprehensive national health reform, the Kaiser Family Foundation has two reports and an updated fact sheet that examine state-level health reform in Massachusetts and the lessons it offers for policymakers in Washington. Consumers’ Experience in Massachusetts: Lessons For National Health Reform and In Pursuit of Affordable Health Care: On the Ground Lessons from Families in Massachusetts, examine the impact of health reform on the lives of ordinary people in the state, including…