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The ACA and Recent Section 1115 Medicaid Demonstration Waivers

Issue Brief
  1. Samantha Artiga and Cindy Mann. New Directions for Medicaid Section 1115 Waivers: Policy Implications of Recent Waiver Activity (Kaiser Commission on Medicaid and the Uninsured, 2005), http://www.kff.org/medicaid/issue-brief/new-directions-for-medicaid-section-1115-waivers/.

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  2. All HIFA waivers required to include at least a feasibility study of premium assistance.

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  3. Status of State Action on the Medicaid Expansion Decision, 2014.  (Kaiser Family Foundation).  http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/

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  4. State Profiles: How Will the Uninsured Fare Under the Affordable Care Act?  http://www.kff.org/state-profiles-uninsured-under-aca/

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  5. Martha Heberlein, Tricia Brooks, Samantha Artiga and Jessica Stephens. Getting into Gear for 2014: Shifting New Medicaid Eligibility and Enrollment Policies into Drive (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, November 2013) http://kff.org/medicaid/report/getting-into-gear-for-2014-shifting-new-medicaid-eligibility-and-enrollment-policies-into-drive/

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  6. Robin Rudowitz, Samantha Artiga and Rachel Arguello.  A Look at Section 1115 Medicaid Demonstration Waivers Under the ACA: A Focus on Childless Adults (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, October, 2013)  http://www.kff.org/medicaid/issue-brief/a-look-at-section-1115-medicaid-demonstration-waivers-under-the-aca-a-focus-on-childless-adults/

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  7. Arkansas Medicaid, Health Care Independence (a/k/a Private Options) § 1115 Waiver – FINAL (Aug. 2, 2013), available at https://www.medicaid.state.ar.us/general/comment/demowaivers.aspx; Arkansas Health Care Independence Program (Private Option), CMS Special Terms and Conditions (Sept. 27, 13), available at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ar/ar-private-option-ca.pdf

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  8. Iowa Dep’t of Human Servs., Iowa Marketplace Choice Plan § 1115 Waiver Application (Aug. 2013), available at http://www.dhs.state.ia.us/uploads/IAMktplaceChoice1115_Final.pdf

    Iowa Marketplace Choice Plan, CMS Special Terms and Conditions (Jan. 1, 2014-Dec. 31, 2016), available at http://www.dhs.state.ia.us/uploads/Iowa_Marketplace_Choice_STCs_12_30_13%20Final.pdf

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  9. MaryBeth Musumeci.  Medicaid Expansion Through Premium Assistance: Arkansas, Iowa, and Pennsylvania’s Proposals Compared (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, December 2013)  http://www.kff.org/health-reform/fact-sheet/medicaid-expansion-through-premium-assistance-arkansas-and-iowas-section-1115-demonstration-waiver-applications-compared/

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  10. MaryBeth Musumeci. Medicaid Expansion Through Marketplace Premium Assistance  (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, September 2013), http://www.kff.org/medicaid/fact-sheet/medicaid-expansion-through-marketplace-premium-assistance/.

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  11. Laura Snyder and Robin Rudowitz, Premiums and Cost-Sharing in Medicaid: A Review of Research Findings.   (Kaiser Commission on Medicaid and the Uninsured, February 2013).  http://kff.org/medicaid/issue-brief/premiums-and-cost-sharing-in-medicaid-a-review-of-research-findings/

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  12. Michigan Department of Community Health, Healthy Michigan § 1115 Demonstration Application (November 8, 2013)

    Michigan Department of Community Health, Healthy Michigan § 1115 Demonstration (December 30, 2013), available at http://www.michigan.gov/documents/mdch/Healthy_Michigan_Plan_1115_Demonstration_Approval_443686_7.pdf

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  13. Pennsylvania Dep’t of Public Welfare, Draft Healthy Pennsylvania 1115 Demonstration Application (Dec. 2013), available athttp://www.dpw.state.pa.us/ucmprd/groups/webcontent/documents/document/p_039654.pdf.

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  14. The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers.  (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, March 2012)  http://kff.org/health-reform/fact-sheet/the-new-review-and-approval-process-rule/

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  15. Laura Snyder and Robin Rudowitz, Premiums and Cost-Sharing in Medicaid: A Review of Research Findings.   (Kaiser Commission on Medicaid and the Uninsured, February 2013).  http://kff.org/medicaid/issue-brief/premiums-and-cost-sharing-in-medicaid-a-review-of-research-findings/

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  16. Federal Register Vol. 78, No. 135, July 15, 2013, pp. 42307-42310.

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  17. The ACA has an optional state plan category for people above 138% at 42 CFR 435.218.  States would receive the traditional Medicaid match for this population, not the ACA enhanced match for those newly eligible.

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  18. New York Department of Health, 3ADM-03 - Medicaid Eligibility Changes under the Affordable Care Act (ACA) of 2010, (Albany, NY: New York Department of Health,) September 2013. http://www.health.ny.gov/health_care/medicaid/publications/adm/13adm3.htm.

    Vermont Agency of Human Services, Vermont Global Commitment 1115 Demonstration Extension Request Submitted to CMS. (Montpelier, VT: Vermont Agency of Human Services,) revised May 13, 2013. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/vt/vt-global-commitment-to-health-pa.pdf.

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  19. Indiana will maintain its enrollment cap and other core components of its waiver, which requires higher cost-sharing contributions and provides more limited benefits than the state’s traditional Medicaid state plan benefits package. Oklahoma will continue to provide limited subsidized coverage under the Insure Oklahoma waiver.  See:  Healthy Indiana Plan and the Affordable Care Act.  Waivers (Kaiser Commission on Medicaid and the Uninsured, December 2013)  http://kff.org/medicaid/fact-sheet/healthy-indiana-plan-and-the-affordable-care-act/

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  20. The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid.  (Kaiser Commission on Medicaid and the Uninsured, October 2013).  http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/

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  21. Wisconsin Department of Health Services. BadgerCare+ Reform Project Waiver (December 31, 2013), http://www.dhs.wisconsin.gov/badgercareplus/waivers.htm.

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