News Release

A Guide to Understanding Medicaid Expansion Waivers as States Debate What to Do Under the ACA

With the recent governors’ elections in  Kentucky and Louisiana refocusing attention on state Medicaid expansion decisions, a newly updated issue brief from the Kaiser Family Foundation provides an overview of the waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana — that are pursuing alternative Medicaid expansions under the Affordable Care Act. For journalists and others, the brief helps inform the debate in additional states that may consider pursuing Medicaid expansion waivers by reviewing key provisions related to premiums, cost sharing and benefits that have been approved by the Centers for Medicare and Medicaid Services (CMS), and noting those that have been turned down.

Read the Brief

Currently, Arizona and Michigan have expansion waivers pending with CMS that would amend current expansion programs. Additional states that either have considered, or are considering, pursuing waivers to expand Medicaid include Tennessee, Utah and Alabama. The newly elected governor in Kentucky has indicated he would like to amend Kentucky’s current traditional expansion through a waiver. States also have the option of pursuing a traditional Medicaid expansion under the ACA, as the governor-elect of Louisiana has indicated he would like to do.

The full document, The ACA and Medicaid Expansion Waivers, is available at

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The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.