This issue brief analyzes key themes in 19 capitated § 1115 and § 1915(b)/(c) Medicaid managed long-term services and supports (MLTSS) waivers approved to date by the Centers for Medicare and Medicaid Services (CMS) with a focus on covered populations and services, provisions aimed at expanding beneficiary access to HCBS, beneficiary protections, and quality measurement and oversight.
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
- 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
- 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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This fact sheet provides an overview of the Healthy Indiana Plan, Indiana’s 1115 waiver demonstration project, and how it relates to the Affordable Care Act’s Medicaid expansion.
Long-Term Services and Supports in the Financial Alignment Demonstrations for Dual Eligible Beneficiaries
This issue brief compares the treatment of LTSS in the seven approved capitated financial alignment demonstrations for dual eligible beneficiaries.
Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries
This chart and a related fact sheet provide a snapshot of enrollment in the capitated financial alignment demonstrations by state for beneficiaries who are dually eligible for Medicare and Medicaid as of June, 2015.
Based on stakeholder interviews and early data on coverage, reduced uncompensated care costs, and other topics, this issue brief provides an initial look at implementation of Arkansas’ Section 1115 Medicaid expansion demonstration waiver to require most adults newly eligible for Medicaid through the Affordable Care Act’s Medicaid expansion to enroll in Marketplace plans.
The ‘Private Option’ Medicaid Expansion in Arkansas Has Helped Reduce the Uninsured Rate and Uncompensated Care Costs While Boosting the State’s ACA Marketplace
A new issue brief from the Kaiser Family Foundation finds that Arkansas’ “private option” Medicaid expansion has helped reduce the number of uninsured and bring down uncompensated care costs while strengthening the state’s ACA marketplace. A Look at the Private Option in Arkansas draws upon early data as well as…
This fact sheet provides a summary of the approved waiver in New Hampshire. New Hampshire has already implemented the ACA Medicaid expansion, but state legislation required the state to submit a waiver to implement mandatory Qualified Health Plan (QHP) premium assistance beginning in January 2016.
Building on an earlier brief that provided an overview of the components of DSRIP waivers, this analysis relied upon interviews with stakeholders to identify emerging trends and themes from DSRIP waivers in four states – California, Massachusetts, New York and Texas. It highlights that DSRIP waivers are spurring major change in relationships among providers; allowing providers to launch new initiatives aimed at improving care and reducing costs; and fostering a stronger focus on the social service needs of Medicaid beneficiaries. At the same time, the rapid pace of implementation is straining the ability of stakeholders to keep pace, including consumer advocates who are hard-pressed to track and respond to the DSRIP-driven changes that are fundamentally re-shaping the way that care is delivered to Medicaid beneficiaries.
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.
This fact sheet provides an overview of changes to BadgerCare, Wisconsin’s 1115 waiver demonstration project, and how it relates to the Affordable Care Act’s Medicaid expansion.