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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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Healthy Indiana Plan: Key Facts and Issues

This issue brief provides an overview of Indiana's new Medicaid waiver program, the Healthy Indiana Plan, which is the first that allows a state to use Medicaid funds to provide a benefit package modeled after a high-deductible plan and health savings account to previously uninsured adults. This piece examines key…

Choosing Premium Assistance: What Does State Experience Tell Us?

Premium assistance programs use federal and state Medicaid and State Children’s Health Insurance Program (SCHIP) funds to purchase private coverage. Overall, few states have premium assistance programs, but interest in premium assistance remains high. This brief examines six state premium assistance programs (in Florida, Idaho, Illinois, Oregon, Utah, and Virginia)…

Family Coverage Under SCHIP Waivers

Currently, eleven states cover parents with SCHIP funds via a federal waiver. This paper examines these programs and considers them within the context of the states' efforts to cover children. Issue Brief (.pdf)

The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions

The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and QuestionsThis fact sheet summarizes Vermont’s Section 1115 waiver to make fundamental changes to its Medicaid program that provides long-term services and supports to eligible, low-income state residents. The waiver was designed to increase access to home and community-based…

West Virginia Medicaid State Plan Amendment: Key Program Changes and Questions

This fact sheet summarizes the key changes West Virginia has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. West Virginia will change the benefit package for children and parents, parents will sign a member agreement for themselves and…

KYHealth Choices Medicaid Reform: Key Program Changes and Questions

This fact sheet summarizes the key changes Kentucky has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. Kentucky uses new options related to benefits, cost sharing and long-term care.Fact Sheet (.pdf)

New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility?

A few recent state Medicaid initiatives have emerged that take the program into new directions. States have expressed a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and, in some cases, relying more heavily on the private marketplace.…

Vermont’s Global Commitment Waiver: Implications for the Medicaid Program

This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program.In the fall of 2005, Vermont secured…

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