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
- Show all
- All United States
- District of Columbia
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
- May 11, 2020
Following the release of Beyond the Law: The Challenge of Abortion Coverage in the Marketplaces, various state advocates and commercial plans asked the National Health Law Program for more detailed recommendations on how plans can improve abortion coverage and how they communicate such coverage to potential and current enrollees. In this Issue Brief, NHeLP suggests measures that states and insurers can take under existing legal requirements (advocates could seek to advance policies under both categories).
- May 11, 2020
Studies demonstrate that underserved populations—such as low-income, rural, and Medicaid populations—are not using telehealth as widely as other demographic groups. Long before the COVID-19 pandemic, states and providers had begun to develop innovative initiatives to address these disparities. NHeLP has prepared a list of principles that states should consider as they enact Medicaid policy on telehealth.
- May 6, 2020
States have several paths to address Medicaid coverage for COVID-19, including State Plan Amendments (SPA), section 1135 authority, and other waivers. CMS recently released a SPA template for options related to the pandemic. This issue brief discusses the emerging issues of SPA authority in six states and provides recommendations to advocates and states on how to use the authority to expand Medicaid coverage during and after the emergency.