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

  • St. Louis Effort for Aids v. Huff, United States District Court, Western District of Missouri

    2013 Nonprofit organizations licensed as Navigators under the Affordable Care Act challenged Missouri law that restricted them from providing accurate and complete information about the full range of health insurance options available under the Affordable Care Act to residents of Missouri. Partners: Mehri & Skalet, PLLC

  • Davis v. Shah, Western District of New York and Second Circuit Court of Appeals

    Litigation Team and

    Medicaid beneficiaries in New York brought this lawsuit to compel the New York State Department of Health to cover medically necessary compression stockings and prescription footwear through the State’s Medicaid program, alleging that the failure to do so violated the Medicaid Act, the Americans with Disabilities Act, and Section 504 of the Rehabilitation Act. Partners: Empire Justice Center

  • Amicus: National Federation of Independent Business v. Sebelius and Florida v. United States Department of Health and Human Services, Supreme Court of the United States

    Litigation Team and

    The National Health Law Program filed an amicus brief arguing that the Medicaid expansion in the Affordable Care Act was constitutional and did not impermissibly coerce states. The amicus brief provided a detailed history of the Medicaid program and argued that the ACA’s Medicaid expansion was in keeping with prior expansions and did not alter Medicaid’s fundamental framework. Through this project, the National Health Law Program is executing a comprehensive monitoring and response system directed at judicial threats to Medicaid. We submit amicus briefs in pivotal cases in order to increase awareness and understanding of the Medicaid program among judges and litigants. We are also providing trainings to stakeholders in order to increase their capacity to engage in the judicial process. Our goal is to encourage judicial rulings that better reflect the complexities of Medicaid coverage—how Medicaid works legally and what coverage means to the more than 70 million Americans who depend on Medicaid for their health care needs. Partners: Disability Law Center of Alaska

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