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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; however, it is not yet clear what role Section 1115 waivers will play as the new administration and Congress move to repeal the ACA and debate possible broader changes to Medicaid financing. 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

CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio

This fact sheet discusses CMS’s denial of Ohio’s proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state’s Section 1115 demonstration waiver application.

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The Henry J. Kaiser Family Foundation

Proposed Changes to Medicaid Expansion in Kentucky

On June 22, 2016, Governor Bevin released his proposed Section 1115 demonstration waiver application called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) as an alternative to the current Medicaid expansion which is being implemented through a state plan amendment according to the terms in the ACA. This fact sheet summarized the proposed changes to the current Medicaid expansion in Kentucky.

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Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries

This chart and a related fact sheet show enrollment in the capitated financial alignment demonstrations as of June, 2016.

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The Henry J. Kaiser Family Foundation

What’s At Stake in the Future of the Kentucky Medicaid Expansion?

On June 22, 2016, Governor Bevin released his proposed Section 1115 demonstration waiver proposal called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) as an alternative to the current Medicaid expansion. This brief examines what has happened to coverage, access and utilization and the economic impact of the Medicaid expansion in Kentucky and the implications for changes going forward.

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The Henry J. Kaiser Family Foundation

Michigan’s Medicaid Section 1115 Waiver to Address Effects of Lead Exposure in Flint

On February 13, 2016, Governor Rick Snyder submitted a Medicaid Section 1115 Waiver proposal to the Centers for Medicare and Medicaid Services (CMS) to address issues related to lead exposure in Flint, Michigan. This fact sheet provides some insight into the situation in Flint, Michigan, the history of Medicaid disaster relief waivers and the details of the Medicaid waiver request.

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The Henry J. Kaiser Family Foundation

Medicaid Expansion Waivers: What Will We Learn?

Section 1115 waivers authorize research and demonstration projects that, in the view of the Health and Human Services (HHS) Secretary, further the purposes of the Medicaid program. The ACA implemented new requirements for these waivers, including that states must have a publicly available, approved evaluation strategy. This brief examines some of the major research questions and hypotheses relevant to the federal and state evaluations of Medicaid expansion Section 1115 waivers and explores key challenges that may hamper research and evaluation efforts.

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The Henry J. Kaiser Family Foundation

Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers

This issue brief describes the Medicaid non-emergency medical transportation (NEMT) benefit, how states administer it, and the reasons that beneficiaries frequently use NEMT. It also explores current policy issues related to NEMT in the context of alternative Medicaid expansion waivers.

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The Henry J. Kaiser Family Foundation

Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS

This issue brief compares the financial alignment demonstrations for beneficiaries who are dually eligible for Medicare and Medicaid in states that have memoranda of understanding approved by the Centers for Medicare and Medicaid Services.

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The Henry J. Kaiser Family Foundation

Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?

This issue brief examines states’ approaches to administering wrap-around benefits and cost-sharing in long-standing Medicaid premium assistance programs and the information available to beneficiaries about how to access these program features.

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The Henry J. Kaiser Family Foundation

A Guide to Understanding Medicaid Expansion Waivers as States Debate What to Do Under the ACA

With the recent governors’ elections in Kentucky and Louisiana refocusing attention on state Medicaid expansion decisions, a newly updated issue brief from the Kaiser Family Foundation provides an overview of the waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana — that are pursuing alternative Medicaid expansions under the Affordable Care Act.

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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.