Waiver 1115 Information

Section 1115 Medicaid waivers allow states to explore new options for providing health coverage to persons who would otherwise not be eligible and allow states to examine innovative ways to deliver care by waiving certain requirements of the Medicaid Act.

While waivers can be important tools that can help states respond to the needs of low-income individuals, they also present concerns for health advocates working to protect the rights of Medicaid enrollees and promote transparency in state waiver processes.

Sec. 1115 of the Social Security Act allows the Secretary of Health and Human Services to waive some requirements of the Medicaid Act so that states can test novel approaches to improving medical assistance for low-income people.

Under the current administration, several states are seeking waivers to impose harmful cuts and restrictions. The first set of harmful waivers have been approved for Kentucky and Arkansas, with a number of states seeking to enact similar changes to Medicaid. Learn more about Medicaid waivers and how the National Health Law Program is combating the Trump administration’s illegal use of waivers to weaken Medicaid.

View 1115 Waiver Resources By State

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… results by Fabiola Carrión in Waivers and Demonstrations.
  • December 22, 2022

    An Advocate’s Guide to Medi-Cal Services

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    The National Health Law Program is pleased to present our updated 2022 Advocates Guide to Medi-Cal Services. NHeLP's Medi-Cal Services Guide, first released in 2020, provides an in-depth description of some of the most important services covered in the Medi-Cal program, including prescription drug services, mental health and substance use disorder services, reproductive and sexual health services, gender-affirming services, dental services, children services, among others.  The 2022 updated guide focuses on key changes the Medi-Cal program has undergone in recent years. In particular, relevant chapters now emphasize policy changes implemented pursuant to the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including a new chapter on Case Management and Community-Support Services, which provides insight on new services that have become widely available through implementation of CalAIM. There is also a new addendum summarizing Medi-Cal's telehealth policy in light of changes adopted during the COVID-19 pandemic.  The entire guide can be downloaded or individual chapters accessed below.

  • August 20, 2021

    NHeLP comments on Updating Payment Parameters Rule

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    In the Updating Payment Parameters Rule (UPP Rule), the Centers for Medicare & Medicaid Services proposes several important changes to enrollment in the Affordable Care Act (ACA) Marketplaces. These changes include extending the open enrollment period, establishing a year-around Special Enrollment Period for low income persons, restoring key features of the Navigator program such as providing consumers assistance in using their plans, ending the abortion double-billing provision, and restoring guard rails for Section 1332 waivers. NHeLP comments express strong support for these changes, and suggest areas where CMS can go even further to help consumers and reduce the number of insured people.

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