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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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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…

Section 1115 Medicaid and SCHIP Waivers: Policy Implications of Recent Activities

This policy brief provides an overview of recent Section 1115 waivers and a discussion of key issues. The HIFA initiative, combined with state fiscal pressures, have led to an increase in the number of states seeking Section 1115 waivers. Many of these recent waivers stake out new ground in terms of the scope of changes in coverage that they permit.

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…

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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