Medicaid

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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.

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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  • Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees

    Issue Brief

    This issue brief illuminates the emotional and pocketbook struggles of families who have suffered financial reversals and lost health coverage in the economic recession forcing many to juggle bills, skip prescription medications and postpone visits to the doctor while they scramble to find a new job. Many who once had steady employment and incomes have had to turn to Medicaid and the State Children’s Health Insurance Program for the first time, even as those programs…

  • Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession

    Report

    This report relays the perspective of leading state Medicaid directors to describe the fiscal strain on Medicaid and other safety-net programs as enrollment swells and state tax revenues shrink, raising the prospect of program cutbacks. It draws on focused interviews with leading Medicaid directors in November 2008. It augments the most recent Medicaid budget survey report that was based on a survey and interviews with all state Medicaid directors in July and August 2008, at…

  • States’ Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion

    Other Post

    States' Role in Administering the New Part D Low-Income Subsidy Program: A Conference Call Discussion The Medicare Modernization Act (MMA) created a major new subsidy program for an estimated 14 million low-income Medicare beneficiaries that will provide assistance with their cost-sharing obligations under the Part D drug benefit. The MMA requires state Medicaid agencies, along with the Social Security Administration (SSA), to accept applications for the new low-income subsidy. MMA also specifies that people who…

  • Missouri’s 2005 Medicaid Cuts: How Did They Affect Enrollees and Providers?

    Other Post

    Missouri's 2005 Medicaid Cuts: How Did They Affect Enrollees and Providers? This study, prepared for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured, examines the result of sweeping cutbacks that Missouri instituted in its Medicaid program in 2005 in response to state budget shortfalls. Researchers at the Urban Institute found that the number of uninsured people in the state increased, hospitals faced greater demand for uncompensated care and community health centers confronted revenue…

  • Medicaid’s Role in Long-Term Care

    Other Post

    Medicaid and Long-Term Care While Medicaid is the nation’s major source of financing for long-term care services, paying for over 40% of total long-term care, its role is not well understood. Misperceptions on who qualifies and what is covered are common. A fact sheet and a Q & A sheet about Medicaid’s role in long-term care assistance provide basic information on the topic. Medicaid’s Role in Long-Term Care: Q & A Medicaid and Long-Term Care…

  • Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences

    Issue Brief

    Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. This brief reviews the key findings from this recent activity, including the impact on enrollment in public coverage programs, access to care, and providers. Issue Paper (.pdf)

  • Medicaid Payment for Outpatient Prescription Drugs

    Fact Sheet

    This fact sheet summarizes Medicaid’s role as the major source of outpatient pharmacy services for low-income Americans. Medicaid spent $25.4 billion on prescription drugs in fiscal year 2009, and outpatient prescription drug coverage is an optional benefit that all state Medicaid programs currently provide. Fact Sheet (.pdf)