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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 July 2016, 32 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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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.…

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…

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…

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;…

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,…

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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.