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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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State-Specific Section 1115 Waiver Fact Sheets

The Kaiser Commission on Medicaid and the Uninsured is closely following waiver activity to provide information on how these waivers are impacting the uninsured and affecting Medicaid and SCHIP and the coverage provided to low-income beneficiaries. Tennessee Section 1115 Waiver Amendment Proposal Fact SheetCalifornia Section 1115 Waiver Fact SheetColorado Section…

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.…

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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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.