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…
Featured Waivers Resources
This issue brief provides an overview of the Section 1115 Medicaid demonstration waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana — that are pursuing alternative Medicaid expansions under the Affordable Care Act. It reviews key provisions related to premiums, cost sharing and benefits that have been approved in such waivers by the Centers for Medicare and Medicaid Services (CMS), and also notes those that have been turned down.
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Related Waivers Resources
- Proposed Changes to Medicaid Expansion in Kentucky
- Medicaid Expansion Waivers: What Will We Learn?
- Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers
- A Look at the Private Option in Arkansas
- Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?
- Medicaid Expansion in Arkansas
- Medicaid Expansion in Indiana
- Medicaid Expansion in Iowa
- Medicaid Expansion in Michigan
- Medicaid Expansion in Montana
- Medicaid Expansion in New Hampshire
- CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio
- Medicaid Expansion in Pennsylvania: Transition from Waiver to Traditional Coverage
- Proposed Medicaid Expansion in Tennessee
- Proposed Medicaid Expansion in Utah
This slide shows the current status of state decisions to use Section 1115 waivers to expand Medicaid. A total of 31 states including DC have adopted the ACA Medicaid expansion, including 6 states with ACA 1115 ACA expansion waivers. AZ has a pending waiver application that seeks changes to its expansion. MT and NH’s waivers will take effect on 1/1/16. PA originally expanded through a waiver but subsequently transitioned to a state plan amendment. TN and UT have debated waiver proposals which have not been approved by their state legislatures or submitted to CMS.
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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…
This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. For many years, Section 1115 waivers have been used by states to test new coverage approaches not otherwise…
This fact sheet summarizes the Texas health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)
This fact sheet summarizes the Massachusetts health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)
This brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states. While recent waivers and waiver proposals vary in…
This fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010. Both waivers affect hundreds of thousands of…
With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation's 2004 survey of the experiences of Medicaid beneficiaries…
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)
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)