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Medicaid Waiver Tracker: Which States Have Approved and Pending Section 1115 Medicaid Waivers?

This resource tracks states with approved Section 1115 Medicaid waivers and pending waivers (which include new waiver applications, waiver amendments, and renewals). View approved and pending waivers according to waiver category. Related waiver resources are available by topic at the bottom of the page, as are additional details on each approved and pending waiver.

Tracking Section 1332 State Innovation Waivers

This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore up fragile insurance markets, address unique state insurance market issues, or experiment with alternative models of providing coverage to state residents.

Does Employment Lead to Improved Health? New Research Review Finds Mixed Evidence with Caveats that Could Impact Applicability to Medicaid Work Requirements

With nearly a dozen states seeking or implementing waivers to add work requirements for some Medicaid beneficiaries, a central question is whether such policies promote health and therefore promote the goals of the Medicaid program. A new Kaiser Family Foundation report reviews research about the relationship between work and health…

The Relationship Between Work and Health: Findings from a Literature Review

A central question in the current debate over work requirements in Medicaid is whether such policies promote health and are therefore within the goals of the Medicaid program. This brief examines literature on the relationship between work and health and analyzes the implications of this research in the context of Medicaid work requirements.

Explaining Stewart v. Azar: Implications of the Court’s Decision on Kentucky’s Medicaid Waiver

This issue brief summarizes the DC federal district court’s June 29, 2018 decision in Stewart v. Azar, the lawsuit brought by Medicaid enrollees challenging the HHS Secretary’s approval of the Kentucky HEALTH Section 1115 waiver program, which includes a work requirement, premiums, coverage lockouts, and other provisions that the state estimated would lead 95,000 people to lose coverage.

New Analysis Illustrates Potential Impact of Medicaid Work Requirements on Coverage if Implemented Nationally as Called for by House Budget Committee and Senate Legislation

As a number of states pursue Medicaid waivers to require certain beneficiaries to work in order to receive benefits, the House Budget Committee passed a budget resolution this month calling for the enactment of Medicaid work requirements in all states, a goal also advanced in proposed legislation in the Senate…

Implications of a Medicaid Work Requirement: National Estimates of Potential Coverage Losses

A number of states have received approval for, have applied for, or are considering Medicaid waiver proposals that would impose work requirements as a condition of eligibility, and some policymakers are calling for a federal requirement that all states implement work requirements in Medicaid. This analysis provides illustrative scenarios of potential nationwide reductions in Medicaid coverage if all states implemented work requirements similar to those currently proposed. The scenarios assume low and high disenrollment rates tied to compliance with the work requirements and related problems with reporting, based on disenrollment rates reported in existing studies of the effect of Medicaid reporting requirements and state estimates of enrollment under proposed waivers.

Key Questions about Medicaid Payment for Services in “Institutions for Mental Disease”

With the opioid epidemic continuing, state interest in expanding access to substance use disorder (SUD) services remains high. Medicaid financed 21% of SUD services and 25% of mental health services in 2014. Section 1115 waivers related to behavioral health remain the most frequent type of waiver sought and obtained by states, with most requesting authority to use federal Medicaid funds for services provided in “institutions for mental disease” (IMDs). Since Medicaid’s inception, Congress has prohibited states from using Medicaid funds for IMD services for non-elderly adults. This brief provides new data and answers key questions about the Medicaid IMD payment exclusion as waiver activity continues, and Congress considers legislative changes, including a House bill that would restrict IMD SUD services to those with opioid use disorder, excluding those with other SUDs.

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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.