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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

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…

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The Henry J. Kaiser Family Foundation

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…

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The Henry J. Kaiser Family Foundation

Primers on Key Health Care Topics and Programs

The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system.Medicaid: A PrimerMedicare: A PrimerThe Uninsured: A PrimerHealth…

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The Henry J. Kaiser Family Foundation

Federal Medicaid Waiver Financing:  Issues for California

Federal Medicaid Waiver Financing: Issues for CaliforniaThis issue brief focuses on the potential fiscal implications of a section 1115 Medicaid waiver for California.Report (.pdf)

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The Henry J. Kaiser Family Foundation

Tennessee’s New “Medically Necessary” Standard:  Uncovering the Insured?

Tennessee's New “Medically Necessary” Standard: Uncovering the Insured?This policy brief describes a new standard passed by Tennessee’s legislature for determining whether an item or service is “medically necessary” under the state’s Medicaid program, TennCare. The brief concludes with some questions regarding the implications of the new standard for the populations…

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The Henry J. Kaiser Family Foundation

Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable

Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for…

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The Henry J. Kaiser Family Foundation

Medicaid:  Current Benefits and Flexibility

Medicaid: Current Benefits and FlexibilityTwo issue briefs discuss the minimum requirements for states to receive federal Medicaid matching funds and the options states have under federal law and waivers to tailor their Medicaid programs.Medicaid as a Health Insurer: Current Benefits and FlexibilityMedicaid as a Long-term Care Program: Current Benefits and…

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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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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.