Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. This brief reviews the key findings from this recent activity, including the impact on enrollment in public coverage programs, access to care,…
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.
Issue Brief See More
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.
Slide See More
- view as grid
- view as list
New Directions for Medicaid Section 1115 Waivers: Policy Implications of Recent Waiver ActivitySeventeen states have had comprehensive Section 1115 waivers approved since January 2001. This brief provides an overview of this recent waiver activity and reviews the implications for coverage and access to care.Policy Brief (.pdf)
This fact sheet provides a brief introduction to Section 1115 waivers in the Medicaid program and highlights policy issues related to recent waiver activity. Fact Sheet (.pdf)
The Impact of Medicaid Reductions in Oregon: Focus Group InsightsOregon is one state that has significantly restructured its Medicaid program, known as the Oregon Health Plan (OHP), in response to budget pressures. As part of these changes, it has implemented significant benefit reductions and increased premiums and cost sharing in…
This new fact sheet summarizes Tennessee’s proposed waiver amendment to its TennCare program, which was submitted to the federal government in September 2004.
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…
Oregon Section 1115 Waiver
Utah Section 1115 Waiver Fact Sheet (.pdf)
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)
The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon’s Medicaid Program
The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon's Medicaid ProgramOregon recently restructured its Medicaid program through a Section 1115 waiver and other program changes, largely in response to particularly difficult state budget problems. This report summarizes…