Medicaid

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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  • Medicaid’s Role for Black Americans

    Fact Sheet

    This fact sheet examines Medicaid's role for black Americans. It includes data on Medicaid's coverage of black Americans and the program's impact on their access to care, as well as the impacts of the recent recession and the coming expansion of Medicaid under health reform on enrollment in Medicaid among black Americans. The fact sheet also has a chart showing state-by-state data on health insurance coverage of black Americans. Fact Sheet (.pdf)

  • Enhanced Medicaid Match Rates Expire in June 2011

    Fact Sheet

    This fact sheet discusses the role played by the enhanced federal Medicaid matching funds available to states through the American Recovery and Reinvestment Act of 2009 (ARRA), and the implications for state Medicaid programs as that extra assistance expires June 30, 2011. States used the ARRA enhanced Medicaid funding to address Medicaid funding shortfalls during the economic downturn, and to mitigate program cuts and address budget shortfalls. As national unemployment has increased in recent years…

  • State Options That Expand Access to Medicaid Home and Community-Based Services

    Report

    This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically have been for institutional, rather than home and community-based, services. Over the past two decades, major efforts have been undertaken by states and the Centers…

  • Medicaid Update: Expenditures and Beneficiaries in 1994 – Policy Brief

    Issue Brief

    Medicaid Expenditures and Beneficiaries: 1994 Update October 1998 Medicaid is the nation's major public financing program for low-income Americans. After several years of rapid increase in the early 1990s, enrollment and spending growth have moderated and returned to historical levels. For the second consecutive year, annual growth in Medicaid spending was under 10 percent. The estimates presented in this policy brief are based on analyses prepared by The Urban Institute and update previous analyses conducted…

  • Medicaid Eligibility for Families and Children

    Other Post

    Part 5 Appendix Table 1: Medicaid Eligibility Levels for Pregnant Women and Children Pregnant Women, Infants and Children(as of May 20, 1998) Other Eligibility Categories Pregnant Women and Infants Children Under Age 6 Children Ages 6 to 14 Children Ages 14 to 19 Asset Test Required for Children (4) Max. AFDC Payments (7/16/96) (5) Medically Needy, 1996 (percent of Federal Poverty Level) United States 133 133 100 45 49 Alabama 133 133 100 100 No…

  • California's "Bridge to Reform" Medicaid Demonstration Waiver

    Fact Sheet

    This issue brief provides an overview of California's "Bridge to Reform" Medicaid Demonstration Waiver, which was approved in 2010 and will make up to roughly $8 billion in federal Medicaid matching funds available to California over a five-year period to expand coverage to low-income uninsured adults and preserve and improve the county-based safety-net. The waiver also allows the state to enroll Medicaid-eligible seniors and persons with disabilities into managed care plans that meet specified readiness…

  • Pulling It Together: Medicare, Medicaid, and The Multiplier Effect

    Perspective

    We are witnessing a battle in Washington right now about the future of health care’s two big public programs, Medicare and Medicaid. It’s a budget battle, it’s an ideological battle, it’s a partisan political battle, and while it might not always be obvious following the debate, it’s a high stakes battle for people. In 2011, over a hundred million low-income, disabled, and elderly beneficiaries will be served by the two programs. Many of the proposals…

  • SCHIP Program Enrollment: June 2003 Update

    Report

    This SCHIP enrollment report finds that overall enrollment growth is slowing and enrollment declined in 13 states. It also found that some states are capping enrollment and a handful of sates are reducing eligibility and benefits under SCHIP. Report (.pdf)