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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 July 2016, 32 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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The Henry J. Kaiser Family Foundation

Interactive Tool Provides an Overview of Delivery System and Payment Reform Efforts in Medicaid Programs

A new interactive tool from the Kaiser Family Foundation provides an overview of the increasing number of delivery system and payment reform efforts that are underway as alternatives to traditional fee-for-service arrangements in state Medicaid programs across the country. Users can scroll over the interactive map and see highlights of…

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The Henry J. Kaiser Family Foundation

Mapping Medicaid Delivery System and Payment Reform

This interactive provides state-by-state data on Medicaid delivery system and payment reform initiatives. Users can track state Medicaid managed care, patient-centered medical home (PCMH), Health Home, Accountable Care Organization (ACO), and Delivery System Reform Incentive Payment (DSRIP) waiver activity.

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The Henry J. Kaiser Family Foundation

Early Insights from Commonwealth Coordinated Care: Virginia’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Virginia is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

Early Insights From Ohio’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Ohio is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Massachusetts is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

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.

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The Henry J. Kaiser Family Foundation

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.

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Web Briefing for Journalists: Key Issues Around Medicaid Expansion Efforts in the States

To help reporters understand the national landscape and issues surrounding the Medicaid expansion, KFF holds a web briefing exclusively for journalists with Medicaid experts Laura Snyder and Robin Rudowitz.

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The Henry J. Kaiser Family Foundation

An Overview of Actions Taken by State Lawmakers Regarding the Medicaid Expansion

The ACA Medicaid expansion has garnered different responses from statelawmakers – Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.

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The Henry J. Kaiser Family Foundation

Medicaid Expansion in Arkansas

This fact sheet summarizes key features of AR’s Medicaid expansion waiver.

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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.