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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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Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

While Congress continues to consider repeal and replacement of the Affordable Care Act (ACA) as well as fundamental changes to the structure and funding of the Medicaid program, states and the Administration may achieve major changes to Medicaid through the use of Section 1115 Medicaid waivers. In April, 2017, Maine and Wisconsin released for public comment at the state level proposed waivers that include many of these provisions. Unlike previous waivers that encompass the ACA’s Medicaid expansion, Wisconsin and Maine are seeking waiver authority to make significant changes to Medicaid that would affect non-expansion Medicaid populations.

Kaiser Media Fellowships 2017 Indiana Site Visits

In April 2017, as Indiana officials began roles in the Trump Administration’s health care leadership, the Foundation invited a group of journalists with a strong focus on health policy and state health reform to participate in a week-long fellowship focused on Indiana’s health care landscape and its approach to expanding…

State Medicaid Expansion Approaches

Current Status of State Medicaid Expansion Decisions States Did the state expand Medicaid?* How did the state expand Medicaid? In non-expansion states: Has there been legislative or administrative activity to pursue expansion in 2017?* How many uninsured adults could gain Medicaid if the state expanded?* United…

Don’t Expect Medicaid Work Requirements to Make a Big Difference

Under the Trump Administration, some Republican governors may look to move their Medicaid programs in a more conservative direction. In his latest column for Axios, Drew Altman discusses the arguments about Medicaid “work requirements” and why few people are likely to be affected by them in practice.

Brief Examines State Requests to Impose Work Requirements in Medicaid

The proposed American Health Care Act (AHCA) includes a state option to make Medicaid eligibility for nondisabled, nonelderly, non-pregnant adults conditional upon satisfaction of a work requirement. Although the Centers for Medicare and Medicaid Services denied all state Section 1115 waiver requests to institute such work requirements under the Obama…

Medicaid and Work Requirements

This issue brief reviews the current status of states’ Section 1115 waiver requests relating to Medicaid work requirements and identifies key policy questions to consider in terms of the impact on beneficiaries, states, and other stakeholders.

All About Section 1115 Medicaid Waivers

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,…

Key Themes in Section 1115 Medicaid Expansion Waivers

This issue brief focuses on Section 1115 waivers that implement the ACA’s Medicaid expansion and highlights themes in approved, pending, and denied provisions to date as well as key issues to watch looking ahead. Additional detail about each state’s waiver is provided in the Appendix tables.

Seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) currently are implementing the ACA’s Medicaid expansion through a Section 1115 demonstration waiver. The previous Administration denied Ohio’s waiver application. Two states (Kentucky and Indiana) currently have Medicaid expansion waivers pending before the Centers for Medicare and Medicaid Services (CMS).

3 Key Questions: Section 1115 Medicaid Demonstration Waivers

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. This brief answers key questions about Section 1115 waiver authority, the current landscape of demonstration waivers and what to watch going forward.

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