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 Andy DiAntonio in Waivers and Demonstrations.
  • July 23, 2013

    Restrictions on the Scope of Section 1115 Waivers in the Medicaid Program

    Restrictions on the Scope of Medicaid Waivers Under ' 1115 of the Social Security Act In August, 2001, the Centers for Medicare and Medicaid Services (CMS) announced the Health Insurance Flexibility and Accountability (HIFA) Demonstration Initiative. HIFA encourages states to seek waivers of various provisions of the Medicaid Act and the State Children=s Health Insurance Program in order to expand basic health insurance coverage to groups not currently eligible to receive benefits under those programs.  In return, CMS has promised the states fast-track consideration of their waiver requests, and the "flexibility" to limit the benefits and rights of some current recipients in order to meet CMS= requirement that any expanded coverage not cost the federal government any more money than it is now paying to a state.  With HIFA, CMS has once again focused attention on its powers under ' 1115 of the Social Security Act (42 U.S.C. '1315) to waive various provisions of the Medicaid Act in furtherance of "demonstration projects." This paper examines some of the substantive and procedural limitations on those powers.   The language of ' 1115 provides the starting point for any analysis of the scope of CMS= waiver authority.  It states,…

  • July 23, 2013

    Medicaid Program – Demonstration Proposals Pursuant to Section 1115(a) of the Social Security Act

  • April 11, 2013

    Health Advocate: Section 1115 Waivers: More than Meets the Eye

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