Medicaid Waiver Tracker: Which States Have Approved and Pending Section 1115 Medicaid Waivers?
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. On June 29, 2018, the DC federal district court issued a decision in Stewart v. Azar. The court invalidated the Kentucky HEALTH waiver approval (with the exception of Kentucky’s IMD SUD payment waiver authority) and sent it back to HHS to reconsider. 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.
Approved and Pending Section 1115 Medicaid Waivers, as of July 12, 2018
Note: Pending waivers include new applications, amendments to existing waivers, and renewal/extension requests. Pending waiver applications are not included in this tracker until they are officially accepted by CMS and posted on Medicaid.gov.
Some states have multiple waivers, and many waivers are comprehensive and may fall into a few different areas. Pending waivers include new applications, amendments to existing waivers, and renewal/extension requests. State waiver renewals that do not propose changes and amendments that are technical in nature are excluded from this tracker and the accompanying tables. This map does NOT include/capture states mandating managed care through Section 1115 (since waiver authority is not generally required for these initiatives) and does not capture delivery system reform, behavioral health, or LTSS initiatives that do not require Section 1115 expenditure authority/federal funds. For additional details on what is included in each category, see category-specific notes.
Download Waiver Tables
- Explaining Stewart v. Azar: Implications of the Court’s Decision on Kentucky’s Medicaid Waiver
- Section 1115 Medicaid Demonstration Waivers: A Look at the Current Landscape of Approved and Pending Waivers
- Web Briefing for Journalists: A Closer Look at the Evolving Landscape of Medicaid Waivers (recording and slides)
- How Medicaid Section 1115 Waivers Are Evolving: Early Insights About What to Watch
- Current Flexibility in Medicaid: An Overview of Federal Standards and State Options
- Key Themes in Medicaid Section 1115 Behavioral Health Waivers
- Key Questions about Medicaid Payment for Services in “Institutions for Mental Disease”
- 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?
- How Might Older Nonelderly Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waivers?
- 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