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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. The Trump administration recently signaled in a letter to governors that CMS would be open to considering waiver requests concerning work requirements in Medicaid, for instance, and some states may wish to experiment with premiums and cost-sharing requirements. 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 New Medicaid and CHIP Waiver Initiatives

A new report describes past waiver activity, the principles of the new HIFA initiative, and related policy implications. Background Paper Appendix: Side-by-Side Comparison

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…

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.

Healthy Indiana Plan and the Affordable Care Act

This fact sheet provides an overview of the Healthy Indiana Plan, Indiana’s 1115 waiver demonstration project, and how it relates to the Affordable Care Act’s Medicaid expansion.

Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal

This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.

Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

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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.