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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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One Year into Duals Demo Enrollment: Early Expectations Meet Reality

One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

An Overview of Delivery System Reform Incentive Payment (DSRIP) Waivers

This brief will examine similarities and difference across key elements of DSRIP waivers. The states included in this analysis are: California, Texas, Kansas, New Jersey, Massachusetts, and New York. The key elements of DSRIP initiatives that will be explored in this analysis include: the goals and objectives of the DSRIP initiative; eligible providers; projects and organization; allocation of funds; data collection and evaluation/reporting; and financing of DSRIP waivers.

Proposed Medicaid Expansion in Tennessee

This fact sheet describes Tennessee’s 1115 waiver demonstration project, Insure Tennessee, which expands the State’s Medicaid program under the Affordable Care Act.

An Overview of Actions Taken by State Lawmakers Regarding the Medicaid Expansion

The ACA Medicaid expansion has garnered different responses from statelawmakers – Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.

Proposed Medicaid Expansion in Utah

This fact sheet provides a summary of the proposal to expand Medicaid in Utah. This has not been officially submitted to CMS and needs state legislative approval before it could be implemented.

Medicaid Expansion Through Marketplace Premium Assistance

This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.

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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.