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The ACA and Medicaid Expansion WaiversWaivers Search Results « » The Henry J. Kaiser Family Foundation

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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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)

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…

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,…

Medicaid Section 1115 Waivers: Current Issues

This fact sheet provides a brief introduction to Section 1115 waivers in the Medicaid program and highlights policy issues related to recent waiver activity. Fact Sheet (.pdf)

The Impact of Medicaid Reductions in Oregon:  Focus Group Insights

The Impact of Medicaid Reductions in Oregon: Focus Group InsightsOregon is one state that has significantly restructured its Medicaid program, known as the Oregon Health Plan (OHP), in response to budget pressures. As part of these changes, it has implemented significant benefit reductions and increased premiums and cost sharing in…

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…