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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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The Henry J. Kaiser Family Foundation

Choosing Premium Assistance: What Does State Experience Tell Us?

Premium assistance programs use federal and state Medicaid and State Children’s Health Insurance Program (SCHIP) funds to purchase private coverage. Overall, few states have premium assistance programs, but interest in premium assistance remains high. This brief examines six state premium assistance programs (in Florida, Idaho, Illinois, Oregon, Utah, and Virginia)…

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The Henry J. Kaiser Family Foundation

Louisiana’s Proposed Section 1115 Medicaid Demonstration Project: Estimating the Numbers of Uninsured and Projected Medicaid Costs

This brief analyzes the composition and medical costs of the uninsured in Louisiana after Hurricane Katrina. The estimates in the brief are the first available that are based on a detailed analysis of who the uninsured are in Louisiana, their current medical spending, and what their spending might be under…

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The Henry J. Kaiser Family Foundation

Family Coverage Under SCHIP Waivers

Currently, eleven states cover parents with SCHIP funds via a federal waiver. This paper examines these programs and considers them within the context of the states' efforts to cover children. Issue Brief (.pdf)

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The Henry J. Kaiser Family Foundation

KYHealth Choices Medicaid Reform: Key Program Changes and Questions

This fact sheet summarizes the key changes Kentucky has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. Kentucky uses new options related to benefits, cost sharing and long-term care.Fact Sheet (.pdf)

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The Henry J. Kaiser Family Foundation

West Virginia Medicaid State Plan Amendment: Key Program Changes and Questions

This fact sheet summarizes the key changes West Virginia has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005. West Virginia will change the benefit package for children and parents, parents will sign a member agreement for themselves and…

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The Henry J. Kaiser Family Foundation

The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions

The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and QuestionsThis fact sheet summarizes Vermont’s Section 1115 waiver to make fundamental changes to its Medicaid program that provides long-term services and supports to eligible, low-income state residents. The waiver was designed to increase access to home and community-based…

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The Henry J. Kaiser Family Foundation

New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility?

A few recent state Medicaid initiatives have emerged that take the program into new directions. States have expressed a number of objectives in developing these approaches, including offering beneficiaries greater choice, promoting personal responsibility and healthier behaviors among enrollees, and, in some cases, relying more heavily on the private marketplace.…

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The Henry J. Kaiser Family Foundation

Vermont’s Global Commitment Waiver: Implications for the Medicaid Program

This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program.In the fall of 2005, Vermont secured…

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The Henry J. Kaiser Family Foundation

Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from Utah

With the enactment of the Deficit Reduction Act of 2005, states have gained increased flexibility over benefits and cost sharing for certain currently eligible Medicaid populations without having to obtain a waiver of Medicaid rules. New findings from the Kaiser Family Foundation's 2004 survey of the experiences of Medicaid beneficiaries…

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The Henry J. Kaiser Family Foundation

A Case Study of the Utah Primary Care Network Waiver: Insights into Its Development, Design, and Implementation

This report examines the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports. Also see Health Affairs article, Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from UtahReport (.pdf)

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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.