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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  • Medicaid Matters For Low Income Medicare Beneficiaries: A Video

    Event Date:
    Event

    In this video, Mildred Benham, a 68 year-old dual enrollee who lives in Bloomington, Illinois, describes the role Medicaid plays in providing services that Medicare does not, such as prescription drugs and personal care. Mildred is a typical dual enrollee in that she has multiple conditions, such as fibrosis of the lungs, rheumatoid arthritis, high blood pressure, and cataracts. To control her conditions, she takes 12 prescriptions a day. Because of her physical limitations, Medicaid…

  • The Role of Health Coverage for People with Disabilities: Findings from 12 Focus Groups with People with Disabilities

    Report

    This report presents findings from focus groups conducted with people with a range of disabilities in an effort to understand the challenges they face and their experiences in the health-care system. To capture variations in experiences by source of health insurance, the groups include people covered under Medicare, Medicaid, and private insurance, as well as those no health insurance at all. The report highlights the ways in which various sources of insurance are working for…

  • Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance

    Issue Brief

    Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act (DRA) of 2005 tightened Medicaid eligibility rules related to asset transfers. About 43 percent of all nursing home residents eventually become Medicaid eligible. This brief concludes that for people becoming Medicaid eligible at the time of nursing home admission, 50 percent had…

  • Medicaid Enrollment & Spending Trends

    Fact Sheet

    Medicaid Enrollment and Spending Trends This fact sheet summarizes trends of enrollment and spending in the Medicaid program from 2000 to 2006. Fact Sheet, October 2007 (.pdf) Previous Versions: May 2006 (.pdf) June 2005 (.pdf) February 2001 (.pdf) September 1999 (.pdf) October 1998 (.pdf)

  • Citizenship Documentation Requirements in The Deficit Reduction Act Of 2005:  Lessons From New York

    Report

    Citizenship Documentation Requirements in The Deficit Reduction Act Of 2005: Lessons From New York New York State is one of only four states in the nation that already requires documentation of citizenship for Medicaid applicants (the others are Georgia, Montana and New Hampshire), and the only state with significant implementation experience. New York’s citizenship documentation requirement has been in place since the mid-1970s, and provides a solid base of experience that can inform the implementation…

  • The Impact of Recent Changes in Health Care Coverage for Low-Income People:  A First Look at the Research Following Changes in Oregon’s Medicaid Program

    Issue Brief

    The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon's Medicaid Program Oregon recently restructured its Medicaid program through a Section 1115 waiver and other program changes, largely in response to particularly difficult state budget problems. This report summarizes key findings on the impact of Oregon's changes, based on work conducted by a research collaborative within the state. The experience in Oregon may…

  • Olmstead at Five:  Assessing the Impact

    Report

    This report examines the impact of Olmstead v. L.C. five years after the United States Supreme Court’s 1999 landmark decision. The analysis brings together new research with a synthesis of research undertaken over the past five years, to help policymakers and program administrators understand the meaning of the Americans with Disabilities Act for health programs in Olmstead’s aftermath. Report (.pdf) Related Olmstead Materials

  • 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.