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Under the Affordable Care Act (ACA), Medicaid plays a key role in efforts to reduce the number of uninsured by expanding eligibility to nearly all low income adults with incomes at or below 138 percent of the federal poverty level ($16,242 per year for an individual in 2015) with 100 percent  federal financing for the first three years, gradually decreasing to 90 percent. However, the 2012 Supreme Court ruling on the ACA’s constitutionality effectively made the expansion a state option. As of December 2015, 31 states including DC have adopted the expansion, and nearly all are implementing it as set forth by the law. A limited number of states have obtained or are seeking approval through Section 1115 waivers to implement the expansion in ways that extend beyond the flexibility provided by the law.  In some cases, these alternative models to implement the expansion are seen as a politically viable way to extend coverage and capture enhanced federal matching funds for newly eligible adults.  This page highlights some key resources examining ACA Medicaid expansion waivers and, farther down, also provides the standard search result page for a site-wide search on the “waivers” tag.
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Medicaid Expansion in New Hampshire

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.

Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States

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.

Wisconsin’s BadgerCare Program and the ACA

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.

Medicaid Beneficiaries Who Need Home and Community-Based Services: Supporting Independent Living and Community Integration

This report features nine seniors and people with disabilities living in Florida, Georgia, Kansas, Louisiana, North Carolina, and Tennessee, who rely on home and community-based services (HCBS). These profiles illustrate how beneficiaries’ finances, employment status, relationships, well-being, independence, and ability to interact with the communities in which they live—in addition to their health care—are affected by their Medicaid coverage and the essential role of HCBS in their daily lives.

One Year into Duals Demo Enrollment: Early Expectations Meet Reality

One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

Profiles of Medicaid Outreach and Enrollment Strategies: The Cook County Early Expansion Initiative

The brief provides an overview of the Cook County, Illinois “CountyCare” early expansion waiver experience, which may help inform continued efforts as the Medicaid expansion is implemented across states. It finds that, in just over 12 months, more than 82,000 Cook County residents successfully enrolled in CountyCare coverage, allowing the state and county to get a significant jump start on the Medicaid expansion. Illinois implemented the full Medicaid expansion in January 2014 and automatically transitioned CountyCare enrollees to the expansion. As of March 2014, CountyCare members account for nearly half of the total statewide enrollment of adults into the Medicaid expansion.

Medicaid Expansion in Indiana

This fact sheet summarizes key elements of Indiana’s Section 1115 Medicaid expansion waiver, HIP 2.0.

An Overview of Delivery System Reform Incentive Payment (DSRIP) Waivers

This brief will examine similarities and difference across key elements of DSRIP waivers. The states included in this analysis are: California, Texas, Kansas, New Jersey, Massachusetts, and New York. The key elements of DSRIP initiatives that will be explored in this analysis include: the goals and objectives of the DSRIP initiative; eligible providers; projects and organization; allocation of funds; data collection and evaluation/reporting; and financing of DSRIP waivers.

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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.