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 Catherine McKee in Waivers and Demonstrations.
  • Webinar: Judge Vacates HHS Approvals of Medicaid Work Requirements in Kentucky & Arkansas

    In a recent webinar, National Health Law Program Legal Director Jane Perkins and Senior Attorneys Catherine McKee and Elizabeth Edwards discussed the recent federal court decisions blocking work requirements and other coverage restrictions in the Kentucky and Arkansas Medicaid programs. They discussed the cases as well as key takeaways and unanswered questions. The National Health Law Program, along with national and state partners, challenged the HHS approval of Medicaid work requirements in Stewart v. Azar and Gresham v. Azar. Download the webinar below.

  • National Health Law Program: Comments to HHS on KY Sec. 1115 Waiver Project

    National Health Law Program in comments to the U.S. Department of Health and Human Services, again, urged the agency to reject Kentucky's proposed Medicaid waiver plan that was invalidated by a U.S. District Court in Stewart v. Azar. The Kentucky plan is again before HHS because the district court remanded it to the agency with direction to re-consider, within the bounds of Medicaid law, the legality of Kentucky's proposed plan. National Health Law Program again argues that the Kentucky waiver plan will lead to substantial numbers of individuals and families losing health care coverage, with many of them unable to meet the onerous requirements of Kentucky's work requirement. The work requirement's attempt at exempting "medically frail" individuals, data shows, will not do so adequately leaving many individuals with disabilities "more likely to lose benefits."

  • Summary of Lawsuit Filed Against HHS Approval of Kentucky Waivers

    On January 12, 2018 the Department of Health and Human Services (HHS) approved numerous section 1115 waivers in Kentucky (KY Waivers). Because the approvals violate numerous provisions of law and will gravely harm hundreds of thousands of Kentuckians, the National Health Law Program (NHeLP) brought a lawsuit challenging them on January 24, 2018. NHeLP brought the lawsuit together with the Kentucky Equal Justice Center and the Southern Poverty Law Center. This summary lays out the basics of the lawsuit, the legal claims, as well as next steps for the litigation.

  • HHS Approves Harmful 1115 Waivers in Kentucky

    Leo Cuello and

    Earlier today, HHS approved the "Kentucky HEALTH" section 1115 waiver. The approval allows Kentucky to ignore numerous critical and long-standing Medicaid protections for eligible Kentuckians. The approved project is effectively a health care cut that will worsen or eliminate access to Medicaid for low-income individuals. It is a huge step backwards for Kentucky's Medicaid expansion, which had been held out as a national model.

  • Quick Review: Transparency, Opportunity for Comment

    A Quick Review of transparency and opportunity for public comment in requests for Section 1115 Waivers. In this brief overview, Senior Attorney Catherine McKee, Legal Director Jane Perkins, and Managing Attorney of the DC office Mara Youdelman note, "The importance of the transparency and public accountability requirements has never been greater," as the HHS secretary has expressed a willingness to approve demonstrations that include work requirements, eliminate presumptive eligibility, and impose greater premiums and cost-sharing than the Medicaid Act allows.

  • Sec. 1115 Waiver Requests: Transparency & Opportunity for Public Comment

    With HHS Secretary Tom Price open to Section 1115 waivers in Medicaid that could include work requirements,  state health advocates must be vigilant in ensuring waivers do not contravene Medicaid law. The Affordable Care Act (ACA) amended Sec. 1115 to require greater transparency and opportunity for public comment on proposed demonstration waivers considered by states and the Centers for Medicare & Medicaid Services (CMS). In this Issue Brief, Senior Attorney Catherine McKee and Legal Director Jane Perkins provide an in-depth look at the process for application, for approving Sec. 1115 waivers, requirements for monitoring approved waivers, and highlight steps advocates should take "to ensure that states and CMS consider the proposal's potential effects on Medicaid enrollees."

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