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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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Medicaid Expansion Through Marketplace Premium Assistance

This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

Florida Medicaid Reform Waiver: Early Findings and Current Status

Florida Medicaid Reform Waiver: Early Findings and Current StatusThis policy brief provides an overview of the Florida Medicaid reform and a summary of available research findings to date from various evaluators of the program. It was issued at the same time as a separate Health Affairs article highlighting findings from…

Premium Assistance in Medicaid and CHIP: An Overview of Current Options and Implications of the Affordable Care Act

Premium assistance is the use of public funds through Medicaid or the Children’s Health Insurance Program (CHIP) to purchase private coverage. States have pursued premium assistance with varied objectives, including covering parents not otherwise eligible for public coverage and promoting the use of private coverage. Implementation of the Affordable Care…

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,…

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…

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).

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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.