This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. For many years, Section 1115 waivers have been used by states to test new coverage approaches not otherwise allowed under Medicaid program rules. Some waivers have also raised important policy issues. Since the passage of the health reform law, several states, including California, have obtained Section 1115 Medicaid demonstration waivers to expand coverage to low-income adults in preparation for the coverage expansions under reform in 2014, while other states have expressed interest in waivers focused on reducing costs to address budget shortfalls.

Issue Brief (.pdf)

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