Medicaid spending on home and community-based service (HCBS) waivers dominates spending on community-based long-term care services offered through the Medicaid program. This paper examines trends in HCBS waiver enrollment and spending in recent years. Report (.pdf)
Featured Waivers Resources
This issue brief provides an overview of the Section 1115 Medicaid demonstration waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana — that are pursuing alternative Medicaid expansions under the Affordable Care Act. It reviews key provisions related to premiums, cost sharing and benefits that have been approved in such waivers by the Centers for Medicare and Medicaid Services (CMS), and also notes those that have been turned down.
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Related Waivers Resources
- Medicaid Expansion Waivers: What Will We Learn?
- Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers
- A Look at the Private Option in Arkansas
- Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?
- Medicaid Expansion in Arkansas
- Medicaid Expansion in Indiana
- Medicaid Expansion in Iowa
- Medicaid Expansion in Michigan
- Medicaid Expansion in Montana
- Medicaid Expansion in New Hampshire
- Medicaid Expansion in Pennsylvania: Transition from Waiver to Traditional Coverage
- Proposed Medicaid Expansion in Tennessee
- Proposed Medicaid Expansion in Utah
This slide shows the current status of state decisions to use Section 1115 waivers to expand Medicaid. A total of 31 states including DC have adopted the ACA Medicaid expansion, including 6 states with ACA 1115 ACA expansion waivers. AZ has a pending waiver application that seeks changes to its expansion. MT and NH’s waivers will take effect on 1/1/16. PA originally expanded through a waiver but subsequently transitioned to a state plan amendment. TN and UT have debated waiver proposals which have not been approved by their state legislatures or submitted to CMS.
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Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for…
Medicaid: Current Benefits and FlexibilityTwo issue briefs discuss the minimum requirements for states to receive federal Medicaid matching funds and the options states have under federal law and waivers to tailor their Medicaid programs.Medicaid as a Health Insurer: Current Benefits and FlexibilityMedicaid as a Long-term Care Program: Current Benefits and…
This fact sheet summarizes the key changes West Virginia has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. West Virginia will change the benefit package for children and parents, parents will sign a member agreement for themselves and…
The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system.Medicaid: A PrimerMedicare: A PrimerThe Uninsured: A PrimerHealth…
Delaware Section 1115 Waiver
This policy brief describes Pharmacy Plus waivers being considered by some states for their Medicaid program and their implications for Medicaid financing. These waivers offer an opportunity for prescription drug coverage for low-income seniors, but they also include a major change in the financing of care for all seniors on…
Federal Medicaid Waiver Financing: Issues for CaliforniaThis issue brief focuses on the potential fiscal implications of a section 1115 Medicaid waiver for California.Report (.pdf)
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…
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…