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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- May 18, 2020
All 50 states and the District of Columbia have made changes to their Medicaid programs in light of the COVID-19 emergency. In most, but not all, cases these changes maintain or expand health coverage and adapt administration of the program to maximize availability of acute and ICU beds and key equipment like ventilators; physically separate COVID patients; and support provider availability and finances. To date, the federal Medicaid agency is approving these changes through legal authorities that allow for temporary changes during an emergency. The end dates of these measures depends on the authority being used by the state. That has consequences. The issue brief uses a Q&A format. It summarizes the current emergency authorities being used by federal and state governments to relax state Medicaid-participation requirements. It also provides action steps that can be taken now to protect broadened Medicaid coverage with respect to the most frequent activities that states are taking.
- May 18, 2020
As the COVID-19 pandemic has demonstrated, Medicaid-eligible and other underserved individuals should be able to benefit from telehealth’s promises. During this public health emergency, several states are working to ensure that Medicaid beneficiaries and others have access to needed services. Below are measures that some states have taken to improve access to health services by expanding telehealth programs.
- May 15, 2020
States can take many actions to protect and increase access to Medicaid health services – including COVID-19 testing and treatment – during the pandemic. This fact sheet highlights ten of the most important advocacy steps you can take to work with your state to ensure appropriate access to Medicaid services during the COVID-19 pandemic.