This brief focuses on Section 1115 Medicaid demonstration waivers related to implementation of the ACA Medicaid expansion (eligible for ACA enhanced matching funds) or other coverage (not eligible for ACA enhanced matching funds). To date, six states are currently implementing or planning to implement the Medicaid expansion through an approved Section 1115 Waiver (Arkansas, Iowa, Michigan, Indiana, New Hampshire, and Montana). New Hampshire and Montana will be effective in January 2016. Pennsylvania received waiver approval, but transitioned to a state plan amendment in mid-2015, so Pennsylvania is not included in the discussion of current and pending waivers.
In addition, two states currently have waiver proposals pending with CMS: Arizona and Michigan. Arizona implemented the expansion, but is now seeking changes based on state law. Michigan has a pending waiver amendment seeking changes required by state law to continue its expansion after April 2016.