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

results by Mara Youdelman in Waivers and Demonstrations.
  • NHeLP Comments on Georgia Section 1332 State Innovation Waiver

    NHeLP submitted comments during the reopened comment period regarding Georgia's Section 1332 State Innovation Waiver. NHeLP recommends that HHS withdraw its approval of this waiver because it would impose a number of unlawful conditions on coverage and access to care for the marketplace and Medicaid populations.

  • The Personal Stories of Those Affected by Indiana’s Section 1115 Waiver

    Indiana began implementing Medicaid work requirements on January 1, 2019. On December 31, 2019, the State will begin suspending the coverage of individuals who have not met the work requirements. Indiana estimated that once fully implemented, the work requirements would result in roughly 24,000 individuals losing Medicaid coverage each year for failing to comply. Because Healthy Indiana 2.0 violates numerous provisions of federal law and will gravely harm tens of thousands of Indiana residents, the National Health Law Program (NHeLP) and co-counsel Indiana Legal Services filed a lawsuit challenging the approval. The lawsuit was filed on behalf of four individuals who currently obtain their health care through Medicaid and will suffer serious harms as a result of the HIP 2.0 extension. This resource discusses how HIP 2.0 has and will continue to affect the named plaintiffs.

  • The Personal Stories of Those Affected by New Hampshire’s Section 1115 Waiver

    On November 30, 2018, the Department of Health and Human Services (HHS) approved New Hampshire’s request to condition Medicaid coverage of medically necessary services needed by low-income adults on work requirements and to waive retroactive coverage. The project is called “Granite Advantage.” Because Granite Advantage violates numerous provisions of federal law and will gravely harm tens of thousands of New Hampshire residents, the National Health Law Program (NHeLP) and co-counsel New Hampshire Legal Assistance and National Center for Law and Economic Justice filed a lawsuit challenging the approval on March 20, 2019.New Hampshire is currently implementing the approved waiver. Retroactive coverage ended on January 1, 2019. Individuals must begin completing work activities in June 2019, and could lose their coverage due to noncompliance beginning August 1, 2019.The class action lawsuit was filed on behalf of four individuals who currently obtain their health care through Medicaid and will suffer serious harms under Granite Advantage. Below are descriptions of how NH Granite Advantage will affect the named plaintiffs: Samuel Philbrick is 26 years old and lives in Henniker with his mother and father. Mr. Philbrick currently works as a cashier in a sporting goods store where he makes $11.33 per hour.…

  • The Personal Stories of Those Affected by Arkansas’ Sec. 1115 Waiver

    National Health Law Program Attorneys Mara Youdelman and Elizabeth Edwards detail stories of individuals in Arkansas who are being harmed by the state's Medicaid work requirement.

  • Fast Facts: Stewart v. Azar Oral Argument

    What you need to know about June 15 oral argument in the federal class action lawsuit from Kentuckians challenging the Trump administration's approval of an onerous Medicaid waiver scheme that includes burdensome work requirements, high premiums, lock outs, and elimination of retroactive health care coverage. Read National Health Law Program's guide on what to expect from oral argument by Mara Youdelman and Jane Perkins.

  • Arkansas’s Sec. 1115 Medicaid Waiver & Its Impact on Health Equity

    The so-called "Arkansas Works" Medicaid waiver scheme recently approved by Trump's HHS is not only legally suspect,  but will disproportionally harm people of color who need health care the most -- these are groups of people who have long been discriminated against in the health care system. The National Health Law Program's Mara Youdelman and Rachel Holtzman explain how the Arkansas Medicaid work requirement will cut off Medicaid to women, Blacks, Hispanics, nonelderly Asians and Native Americans.

  • Arkansas’s Section 1115 Medicaid Waiver & Its Impact on Health Equity

    On March 5, 2018 HHS approved a section 1115 waiver requested by Arkansas. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people of color, women, and people with disabilities. This fact sheet describes that impact.

  • The Personal Stories of Those Affected by Kentucky’s Sec. 1115 Medicaid Waivers

    National Health Law Program Managing Attorney of the D.C. office Mara Youdelman details how Kentucky's Sec. 1115 Medicaid waivers program is harming the lives of the plaintiffs in the federal lawsuit challenging HHS's approval of the radical Medicaid waiver project, which includes an onerous work requirement and cuts to benefits, including retroactive eligibility.

  • Indiana’s Section 1115 Medicaid Waiver & Its Impact on Health Equity

    Earlier today, HHS approved a section 1115 waiver requested by Indiana. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people of color, women, and people with disabilities. This fact sheet describes that impact.

  • Kentucky’s Section 1115 Medicaid Waiver and Its Impact on Health Equity

    Earlier today, HHS approved a section 1115 waiver requested by Kentucky. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people of color, women, and people with disabilities. This fact sheet describes that impact.

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