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.
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- October 18, 2019
In comments to the Department of Housing and Urban Development (HUD), NHeLP expresses strong opposition to the proposed rule change regarding “HUD's Implementation of the Fair Housing Act's Disparate Impact Standard” Notice of Proposed Rulemaking (NPRM). The existing disparate impact rule efficiently and successfully serves the American public as a tool for challenging the structural inequalities that persist in housing and financial markets. Access to safe and affordable housing is important to health, but housing policy--including discriminatory housing practices—often negatively influence place-based inequities. Instead of fulfilling the stated goal of the Fair Housing Act (FHA) to provide for fair housing, the proposed rule will create overwhelming obstacles for people who experience discrimination and then seek to enforce their rights based on a disparate impact claim.
- October 16, 2019
NHeLP comments on Indiana’s Serious Mental Illness/Serious Emotional Disturbance Section 1115 Waiver Request
In comments to the Department of Health and Human Services, the National Health Law Program urges HHS to reject Indiana’s proposed request to waive the Institutions for Mental Diseases (IMD) exclusion. HHS, however, does not have authority to grant the request to waive the IMD exclusion because Indiana has not proposed a genuine experiment, and the Secretary may only waive requirements of the federal Medicaid Act to conduct an experiment or test a novel approach to improve medical assistance for low-income individuals. Furthermore, Section 1115 only permits waiver of those requirements found in 42 U.S.C. § 1396a, and the IMD exclusion lies outside of 42 U.S.C. § 1396a. Last, the proposal risks diverting funds away from appropriate community-based services, undermining decades of progress towards increased community-integration.
- October 15, 2019
On August 12, 2019, the Department of Homeland Security (DHS) released a final rule redefining the term “public charge.” The rule makes fundamental changes to the longstanding application of public charge to the receipt of public benefits for certain immigrants. Nine lawsuits were filed challenging the rule. As of October 14, 2019 federal judges have issued five preliminary injunctions, include three nation-wide court orders, that prevent the rule from going into effect for the time being. The purpose of this issue brief is to provide background information about public charge with a focus on the impact of the rule in the health care context (although the rule also applies to receipt of other public benefits). While the rule has been temporarily blocked by the courts, the final outcome of the rule will not be known until the courts issue their final orders. Until that time, the current policies regarding public charge remain in place.