Filling the need for trusted information on national health issues…

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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Assessing the Role of Recent Waivers in Providing New Coverage

This analysis finds that recent waivers have expanded coverage in important ways in a few states, but, overall, the number of people who have gained new coverage under recent waivers has been quite limited, well below projections and small compared to overall growth in Medicaid enrollment.Issue Paper (.pdf)

Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…

Tennessee’s New “Medically Necessary” Standard:  Uncovering the Insured?

Tennessee's New “Medically Necessary” Standard: Uncovering the Insured?This policy brief describes a new standard passed by Tennessee’s legislature for determining whether an item or service is “medically necessary” under the state’s Medicaid program, TennCare. The brief concludes with some questions regarding the implications of the new standard for the populations…

Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah

With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation's 2004 survey of the experiences of Medicaid beneficiaries…

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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.