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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

Section 1115 Waivers in Medicaid and the State Children’s Health Insurance Program: An Overview

A new policy brief provides a description of the Section 1115 law, its history, and an overview of how it plays a role in the restructuring of Medicaid and SCHIP.

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The Henry J. Kaiser Family Foundation

The New Medicaid and CHIP Waiver Initiatives

A new report describes past waiver activity, the principles of the new HIFA initiative, and related policy implications. Background Paper Appendix: Side-by-Side Comparison

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The Henry J. Kaiser Family Foundation

California Section 1115 Waiver

California Section 1115 Waiver

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The Henry J. Kaiser Family Foundation

Vermont’s Global Commitment Waiver: Implications for the Medicaid Program

This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program.In the fall of 2005, Vermont secured…

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The Henry J. Kaiser Family Foundation

Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements

One mechanism for ensuring that health insurance provides value to consumers for the premiums that they pay, or that others pay on their behalf, is to require insurers to meet a minimum “medical loss ratio” or MLR standard. The MLR is the share of premium revenues that an insurer or…

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The Henry J. Kaiser Family Foundation

Health Care Use and Chronic Conditions Among Childless Adult Medicaid Enrollees in Arizona

Under the Affordable Care Act (ACA), beginning in 2014, Medicaid eligibility will expand to 133% of the federal poverty level for nearly all individuals. Arizona is one of the few states that already cover adults without dependent children in Medicaid through a longstanding Section 1115 waiver. This report, based on…

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The Henry J. Kaiser Family Foundation

Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year

Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to…

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The Henry J. Kaiser Family Foundation

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries…

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The Henry J. Kaiser Family Foundation

Colorado Section 1115 Waiver Fact Sheet

Fact Sheet

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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.