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  • What Are States Proposing for Work Requirements in Medicaid?

    News Release

    With the approval of Kentucky’s Medicaid expansion waiver, the Centers for Medicare and Medicaid Services (CMS) has for the first time granted a state permission to make Medicaid eligibility conditional on meeting a work requirement. Nine other states have waivers pending at CMS that would impose work requirements, including Arizona, Arkansas, Kansas, Indiana, Wisconsin, Maine, New Hampshire, Mississippi and Utah. A new brief from the Kaiser Family Foundation highlights what the work requirements would be in…

  • New KFF Resource Tracks Developments in States’ Section 1115 Medicaid Waivers

    News Release

    A new resource from the Kaiser Family Foundation enables users to keep abreast of Section 1115 Medicaid waivers that are pending or have been approved by the Centers for Medicare and Medicaid Services. KFF’s Medicaid waiver tracker includes interactive maps that allow users to view states’ approved and pending waivers according to category, including Medicaid expansion; work requirements; benefit restrictions, copays and healthy behaviors; enrollment and eligibility restrictions; managed long-term services and supports; and more.…

  • Key Themes in Medicaid Section 1115 Behavioral Health Waivers

    Issue Brief

    State interest in Medicaid Section 1115 behavioral health waivers, including mental health and substance use disorders, remains high. As of November, 2017, there are 15 approved and 11 pending behavioral health waivers in 22 states. This issue brief describes recent waiver activity in four areas: using Medicaid funds to pay for substance use and/or mental health services in “institutions for mental disease” (IMDs), expanding community-based behavioral health benefits, expanding Medicaid eligibility to cover additional people…

  • How Medicaid Section 1115 Waivers Are Evolving: Early Insights About What to Watch

    Issue Brief

    While efforts to pass major federal legislation to repeal and replace the Affordable Care Act (ACA) and restructure and reduce federal Medicaid financing may be on hold temporarily, the focus of the Centers for Medicare and Medicaid Services (CMS) and states is expected to turn to achieving significant Medicaid program changes through Section 1115 demonstration waivers. This issue brief presents three questions to help analyze the evolution of federal waiver policy as new waiver proposals…

  • Medicaid Enrollees and Work Requirements: Lessons From the TANF Experience

    Issue Brief

    This issue brief considers the implications of conditioning Medicaid eligibility on satisfying a work requirement, drawing on state experience with TANF enrollees subject to a work requirement over the past two decades and data about work and the role of health coverage among Medicaid enrollees today.

  • Proposed Medicaid Section 1115 Waivers in Maine and Wisconsin

    Issue Brief

    While the future of legislation to repeal and replace the Affordable Care Act (ACA) and make fundamental changes to the structure and funding of the Medicaid program is uncertain, states and the Administration may achieve major changes to Medicaid through the use of Section 1115 Medicaid waivers. Wisconsin submitted a waiver amendment request to CMS in June 2017 and Maine submitted a waiver application to CMS in August 2017. Unlike previous waivers that encompass the…

  • Proposed Changes to Medicaid Expansion in Kentucky

    Fact Sheet

    On June 22, 2016, Governor Bevin released his proposed Section 1115 demonstration waiver application called Kentucky HEALTH (Helping to Engage and Achieve Long Term Health) as an alternative to the current Medicaid expansion which is being implemented through a state plan amendment according to the terms in the ACA. On July 3, 2017, Kentucky submitted an amendment, proposing several changes, to its pending waiver application to the new Administration. This fact sheet summarizes the proposed…

  • Using Medicaid to Wrap Around Private Insurance: Key Questions to Consider

    Issue Brief

    This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA's Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.