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Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states considerable flexibility in how they operate their programs, beyond what is available under current law, and can have a significant impact on program financing. As such, waivers have important implications for beneficiaries, providers, and states. While there is great diversity in how states have used waivers over time, waivers generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS). Looking ahead, states are likely to continue to request waivers to implement provisions not allowed under current law. The Trump administration recently signaled in a letter to governors that CMS would be open to considering waiver requests concerning work requirements in Medicaid, for instance, and some states may wish to experiment with premiums and cost-sharing requirements. This page highlights key resources examining Section 1115 waivers and, farther down, also provides the standard search result page for a site-wide search on the “waivers” tag.

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The Henry J. Kaiser Family Foundation

Health Care Use and Chronic Conditions Among Childless Adult Medicaid Enrollees in Arizona

Under the Affordable Care Act (ACA), beginning in 2014, Medicaid eligibility will expand to 133% of the federal poverty level for nearly all individuals. Arizona is one of the few states that already cover adults without dependent children in Medicaid through a longstanding Section 1115 waiver. This report, based on…

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The Henry J. Kaiser Family Foundation

Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year

Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to…

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The Henry J. Kaiser Family Foundation

Louisiana’s Proposed Section 1115 Medicaid Demonstration Project: Estimating the Numbers of Uninsured and Projected Medicaid Costs

This brief analyzes the composition and medical costs of the uninsured in Louisiana after Hurricane Katrina. The estimates in the brief are the first available that are based on a detailed analysis of who the uninsured are in Louisiana, their current medical spending, and what their spending might be under…

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The Henry J. Kaiser Family Foundation

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries…

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The Henry J. Kaiser Family Foundation

Colorado Section 1115 Waiver Fact Sheet

Fact Sheet

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The Henry J. Kaiser Family Foundation

Medicaid as a Health Insurer: Current Benefits and Flexibility

This issue brief focuses on one subset of “flexibility” issues: the current federal benefits and cost-sharing rules that apply with respect to acute care. Issue Paper (.pdf)

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The Henry J. Kaiser Family Foundation

Assessing the Role of Recent Waivers in Providing New Coverage

This analysis finds that recent waivers have expanded coverage in important ways in a few states, but, overall, the number of people who have gained new coverage under recent waivers has been quite limited, well below projections and small compared to overall growth in Medicaid enrollment.Issue Paper (.pdf)

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The Henry J. Kaiser Family Foundation

Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…

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The Henry J. Kaiser Family Foundation

Medicaid 1915(c) Home and Community-Based Service Programs: Data Update

Over the last four years, the Commission has been tracking the national development of the three main Medicaid HCBS programs that states can operate. The Commission also began to survey the policies, such as eligibility criteria and waiting lists that states can use to control the growth of spending on…

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The Henry J. Kaiser Family Foundation

Premium Assistance Programs:  How Are They Financed and Do States Save Money?

Premium Assistance Programs: How Are They Financed and Do States Save Money?This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness;…

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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.