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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 Henry J. Kaiser Family Foundation

West Virginia Medicaid State Plan Amendment: Key Program Changes and Questions

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…

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The Henry J. Kaiser Family Foundation

New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility?

A few recent state Medicaid initiatives have emerged that take the program into new directions. States have expressed a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and, in some cases, relying more heavily on the private marketplace.…

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The Henry J. Kaiser Family Foundation

Vermont’s Global Commitment Waiver: Implications for the Medicaid Program

This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program.In the fall of 2005, Vermont secured…

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The Henry J. Kaiser Family Foundation

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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The Henry J. Kaiser Family Foundation

A Case Study of the Utah Primary Care Network Waiver: Insights into Its Development, Design, and Implementation

This report examines the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports. Also see Health Affairs article, Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from UtahReport (.pdf)

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The Henry J. Kaiser Family Foundation

A Comparison of the Seventeen Approved Katrina Waivers

This fact sheet summarizes and compares seventeen states’ approved Medicaid waivers related to Hurricane Katrina evacuees.Fact Sheet (.pdf)

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The Henry J. Kaiser Family Foundation

Premium Assistance Programs:  How Are They Financed and Do States Save Money?

Premium Assistance Programs: How Are They Financed and Do States Save Money?This brief examines premium assistance programs implemented under section 1115 waivers in five states (Illinois, New Jersey, Oregon, Rhode Island, Utah) to determine how they are financed; their eligibility, benefit, and cost sharing requirements; their methods for determining cost-effectiveness;…

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The Henry J. Kaiser Family Foundation

Coverage Gains Under Recent Section 1115 Waivers: A Data Update

This brief assesses the extent to which recent Section 1115 waivers have helped reduce the number of uninsured people and finds that there has been a net gain in coverage of 426,329 people under recent waivers.Issue Paper (.pdf)

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The Henry J. Kaiser Family Foundation

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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The Henry J. Kaiser Family Foundation

Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences

Over the past few years, a number of states have implemented new or increased existing out-of-pocket costs for beneficiaries in their Medicaid, SCHIP, or other public coverage programs. This brief reviews the key findings from this recent activity, including the impact on enrollment in public coverage programs, access to care,…

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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.