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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

Choosing Premium Assistance: What Does State Experience Tell Us?

Premium assistance programs use federal and state Medicaid and State Children’s Health Insurance Program (SCHIP) funds to purchase private coverage. Overall, few states have premium assistance programs, but interest in premium assistance remains high. This brief examines six state premium assistance programs (in Florida, Idaho, Illinois, Oregon, Utah, and Virginia)…

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The Henry J. Kaiser Family Foundation

Health Affairs Article: Florida’s Medicaid Reform: Informed Consumer Choice?

Health Affairs Article: Florida's Medicaid Reform: Informed Consumer Choice?Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to…

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The Henry J. Kaiser Family Foundation

Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses…

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The Henry J. Kaiser Family Foundation

Medicaid 1915(c) Home and Community-Based Service Programs: Data Update

Over the last four years, the Commission has been tracking the national development of the three main Medicaid HCBS programs that states can operate. The Commission also began to survey the policies, such as eligibility criteria and waiting lists that states can use to control the growth of spending on…

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The Henry J. Kaiser Family Foundation

Premium Assistance Programs:  How Are They Financed and Do States Save Money?

Premium Assistance Programs: How Are They Financed and Do States Save Money?This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness;…

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The Henry J. Kaiser Family Foundation

A Comparison of the Seventeen Approved Katrina Waivers

This fact sheet summarizes and compares seventeen states’ approved Medicaid waivers related to Hurricane Katrina evacuees.Fact Sheet (.pdf)

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The Henry J. Kaiser Family Foundation

Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and…

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The Henry J. Kaiser Family Foundation

Premiums and Cost-Sharing in Medicaid

Medicaid, the nation’s public health insurance program for low-income people, now covers nearly 60 million Americans, including many working families, low-income elderly, and individuals with disabilities. Medicaid beneficiaries tend to be poorer and sicker than those enrolled in private insurance. Given these characteristics, federal law limits the extent to which…

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The Henry J. Kaiser Family Foundation

Restructuring Medicaid: Key Elements and Issues in Section 1115 Demonstration Waivers

This policy brief provides background on Section 1115 Medicaid waiver activity, discusses the common provisions of the approved and proposed Section 1115 waivers since 1993, and briefly summarizes the current application of Section 1115 AFDC waivers. It also examines implications of the Section 1115 waivers on the Medicaid program and…

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The Henry J. Kaiser Family Foundation

Pharmacy Plus Waivers: Trade Offs Between Expanding Rx Coverage and Global Caps in Medicaid

The Kaiser Commission on Medicaid and the Uninsured has been monitoring the development of the Pharmacy Plus waiver initiated by the Bush Administration in 2002 and tracking the states that have pending or approved plans. The Commission has developed some materials describing the initiative, examining the financing mechanism, and discussing…

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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.