Section 1115 Medicaid #waivers provide states an avenue to test new approaches in #Medicaid that differ from federal program rules. Use the @KaiserFamFound waiver tracker to keep an eye on what states are pursuing in pending and approved waivers.

Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. 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). On March 14, 2017, the CMS sent a letter to state governors that signaled a willingness to use Section 1115 authority to support work requirements and the alignment of Medicaid programs with private insurance policies.  In November 2017, the CMS posted revised criteria for Section 1115 waiver demonstrations. A number of states have waivers pending at CMS that include provisions not previously approved including drug screening and testing, eligibility time limits, and premiums with disenrollment for non-payment for traditional Medicaid populations. Some of the requests are part of ACA expansion waivers, while others would apply to traditional populations. On January 11, 2018, CMS posted new guidance for state Section 1115 waiver proposals to condition Medicaid on meeting a work requirement. The map below tracks states with approved Section 1115 Medicaid waivers and pending waivers (which include new waiver applications, waiver amendments, and renewals). Use the drop down box to view approved and pending waivers according to waiver category. Related KFF waiver resources are available by topic at the bottom of this page as well as downloadable tables with additional detail on each approved and pending waiver.

• The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
• An Early Look at Medicaid Expansion Waiver Implementation in Michigan and Indiana
• CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio
• Medicaid Expansion Waivers: What Will We Learn?
• Medicaid Premium Assistance Programs: What Information is Available About Benefit and Cost-Sharing Wrap-Around Coverage?
• A Look at the Private Option in Arkansas

• Medicaid and Work Requirements: New Guidance, State Waiver Details and Key Issues
• Understanding the Intersection of Medicaid and Work
• How Might Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waiver Programs?
• Approved Changes in Indiana’s Section 1115 Waiver Extension
• Approved Changes to Medicaid in Kentucky
• A Guide to the Lawsuit Challenging CMS’s Approval of the Kentucky HEALTH Medicaid Waiver
• Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience
• Don’t Expect Medicaid Work Requirements to Make a Big Difference

• Medicaid Retroactive Coverage Waivers: Implications for Beneficiaries, Providers, and States
• Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

• The Effects of Premiums and Cost Sharing on Low-Income Populations: Updated Review of Research Findings
• Medicaid Non-Emergency Medical Transportation: Overview and Key Issues in Medicaid Expansion Waivers

• Medicaid Section 1115 Managed Long-Term Services and Supports Waivers: A Survey of Enrollment, Spending, and Program Policies