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Key Themes in Section 1115 Medicaid Expansion Waivers

This issue brief focuses on Section 1115 waivers that implement the ACA’s Medicaid expansion and highlights themes in approved, pending, and denied provisions to date as well as key issues to watch looking ahead. Additional detail about each state’s waiver is provided in the Appendix tables.

Seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) currently are implementing the ACA’s Medicaid expansion through a Section 1115 demonstration waiver. The previous Administration denied Ohio’s waiver application. Two states (Kentucky and Indiana) currently have Medicaid expansion waivers pending before the Centers for Medicare and Medicaid Services (CMS).

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Interactive Maps: Estimates of Enrollment in ACA Marketplaces and Medicaid Expansion

As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, an interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January. The analysis also includes maps charting the total number of people enrolled under the ACA Medicaid expansion in 2015 in states that implemented the ACA Medicaid expansion, along with the political parties of their governors and U.S. senators.

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Medicaid and Work Requirements

This issue brief reviews the current status of states’ Section 1115 waiver requests relating to Medicaid work requirements and identifies key policy questions to consider in terms of the impact on beneficiaries, states, and other stakeholders.

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An Early Look at Medicaid Expansion Waiver Implementation in Michigan and Indiana

This brief explains key components of Michigan and Indiana’s Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.

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The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review

Research on the effects of Medicaid expansions under the Affordable Care Act (ACA) can help increase understanding of how the ACA has impacted coverage; access to care, utilization, affordability, and health outcomes; and various economic outcomes, including state budgets, the payer mix for hospitals and clinics, and the employment and labor market. This summary reviews findings from 108 studies of the impact of state Medicaid expansions under the ACA published between January 2014 (when the coverage provisions of the ACA went into effect) and January 2017.

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The Henry J. Kaiser Family Foundation

What’s at Stake in a Potential Repeal of the ACA Medicaid Expansion?

President-elect Trump and Republican leaders in Congress have vowed to repeal the Affordable Care Act (ACA) and replace it with an alternative plan. There are now 32 states (including DC) that have adopted the ACA’s Medicaid expansion. While the details of a repeal-and-replace plan are not yet available to assess…

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Restructuring Medicaid in the American Health Care Act: Five Key Considerations

On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected under current law, and 14 million fewer people would be covered by Medicaid than expected under current law. This brief considers five key Medicaid implications of the House bill.

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The Henry J. Kaiser Family Foundation

Proposed Changes to Medicaid Expansion in Kentucky

On June 22, 2016, Governor Bevin released his proposed Section 1115 demonstration waiver application called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) as an alternative to the current Medicaid expansion which is being implemented through a state plan amendment according to the terms in the ACA. This fact sheet summarized the proposed changes to the current Medicaid expansion in Kentucky.

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The Henry J. Kaiser Family Foundation

ACA Medicaid Expansion Drove Nationwide Increase in Health Coverage for People with HIV, First National Analysis Finds

As Congress moves to repeal the Affordable Care Act, a new analysis from the Kaiser Family Foundation provides the first national estimates of changes in health coverage for people with HIV since the law was implemented. It finds that rolling back the law’s Medicaid expansion could significantly impact coverage for…

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The Henry J. Kaiser Family Foundation

11 Million People on Medicare Are Also Covered by Medicaid. What Could Switching to a Medicaid Per Capita Cap Mean for Them?

A major structural change to Medicaid financing such as the per capita cap system called for under the American Health Care Act could have significant implications for the 11 million seniors and people with disabilities who are covered by both Medicare and Medicaid, according to a new brief by the…

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The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.