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; however, it is not yet clear what role Section 1115 waivers will play as the new administration and Congress move to repeal the ACA and debate possible broader changes to Medicaid financing. 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.
Featured Waivers Resources
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).
Issue Brief See More
Related Waivers Resources
- An Early Look at Medicaid Expansion Waiver Implementation in Michigan and Indiana
- Proposed Changes to Medicaid Expansion in Kentucky
- Medicaid Expansion Waivers: What Will We Learn?
- CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio
- Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers
- Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?
- A Look at the Private Option in Arkansas
- Medicaid Section 1115 Managed Long-Term Services and Supports Waivers: A Survey of Enrollment, Spending, and Program Policies
- Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States
- An Overview of Delivery System Reform Incentive Payment (DSRIP) Waivers
- Michigan’s Medicaid Section 1115 Waiver to Address Effects of Lead Exposure in Flint
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. This brief answers key questions about Section 1115 waiver authority, the current landscape of demonstration waivers and what to watch going forward.
Issue Brief See More
- view as grid
- view as list
This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state’s “Bridge to Reform” Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.Issue Brief Read More
This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.Fact Sheet Read More
This brief provides an overview of Section 1115 waiver authority, describes major provisions of waivers that extend coverage to childless adults, and identifies key issues and implications of these waivers looking forward to the Affordable Care Act and beyond.Issue Brief Read More
Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS
This issue brief compares the financial alignment demonstrations for beneficiaries who are dually eligible for Medicare and Medicaid in states that have memoranda of understanding approved by the Centers for Medicare and Medicaid Services.Issue Brief Read More
This fact sheet describes Pennsylvania’s approved 1115 waiver demonstration, Healthy PA, which will implement the ACA’s Medicaid expansion.Fact Sheet Read More
One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.Perspective Read More
The ACA Medicaid expansion has garnered different responses from statelawmakers – Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.Fact Sheet Read More
To help reporters understand the national landscape and issues surrounding the Medicaid expansion, KFF holds a web briefing exclusively for journalists with Medicaid experts Laura Snyder and Robin Rudowitz.Event Read More
This fact sheet provides a summary of the proposal to expand Medicaid in Utah. This has not been officially submitted to CMS and needs state legislative approval before it could be implemented.Fact Sheet Read More