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  • A Guide to Understanding Medicaid Expansion Waivers as States Debate What to Do Under the ACA

    News Release

    With the recent governors’ elections in Kentucky and Louisiana refocusing attention on state Medicaid expansion decisions, a newly updated issue brief from the Kaiser Family Foundation provides an overview of the waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana -- that are pursuing alternative Medicaid expansions under the Affordable Care Act.

  • 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 ACA’s Medicaid expansion, Wisconsin and Maine are seeking waiver authority to make significant changes to Medicaid that would affect non-expansion Medicaid populations.

  • 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.

  • Why Medicaid Work Requirements Aren’t the Same as Welfare Reform

    From Drew Altman

    Drawing on his experience in state welfare reform, Drew Altman, in his Axios column, discusses how new state Medicaid work requirements differ fundamentally from welfare reform, which was built on the idea of a “reciprocal obligation” between both beneficiaries and government to do more.  

  • 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.

  • A First Look at North Carolina’s Section 1115 Medicaid Waiver’s Healthy Opportunities Pilots

    Issue Brief

    Medicaid funds typically cannot be used to pay for non-medical interventions that target the social determinants of health. However, in October 2018, CMS approved North Carolina’s Section 1115 waiver which provides financing for a new pilot program, called “Healthy Opportunities Pilots,” to cover evidence-based non-medical services that address specific social needs linked to health/health outcomes. The pilots will address housing instability, transportation insecurity, food insecurity, and interpersonal violence and toxic stress for a limited number of high-need Medicaid enrollees. This brief summarizes key features of the pilots.