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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- September 17, 2019
An Advocate’s Guide to Reproductive and Sexual Health in the Medicaid Program (“Guide”) will familiarize readers with the basics of the Medicaid program and highlight features that support reproductive and sexual health. Since the Guide was first published in February 2010, the United States Congress passed and President Obama enacted the Patient Protection and Affordable Care Act, commonly known as the Affordable Care Act (ACA). The ACA brought substantial changes to the Medicaid program and the entire health care system, including the modes of access to health coverage and the benefits that must be covered. The Guide provides a brief overview of the Medicaid program, and explains the complex eligibility categories and requirements for the program with a focus on those categories that affect people seeking reproductive and sexual health care. The Guide also details the various reproductive and sexual health services available to Medicaid enrollees. The Guide also describes barriers and protections to accessing reproductive and sexual health services in Medicaid and other publicly funded reproductive and sexual health programs. Lastly, the Guide provides a brief overview of the administrative structure of and application process for the Medicaid program. Wherever possible, we also highlight best practices, policy recommendations,…
- September 12, 2019
All major Democratic candidates agree that the ultimate goal of any health care reform proposal should be universal health care coverage, but disagree about the best way to get there. Some believe the best option is to add a public option, thereby capitalizing on the coverage and affordability gains achieved by the Affordable Care Act, while others believe that exchanging our current fragmented system of insurance for a new single-payer system is the appropriate pathway to lower costs and increased consumer protections. The remainder of the field have staked out ground along the continuum. In this webinar National Health Law Program attorneys Jennifer Lav and Héctor Hernández-Delgado discuss the opportunities and trade-offs inherent in these various proposals, and how each proposal will impact access to health care for low-income individuals and families. (You will need to register for the webinar to watch the recording)
- September 10, 2019
National Health Law Program Comments on Workforce Bridge Program and other Amendments to the Healthy Indiana Program 1115 Waiver Project
In comments to the U.S. Department of Health and Human Services, the National Health Law Program urged Secretary Azar to reject amendments to create an ill-conceived Workforce Bridge Program and add two minor exemptions to Indiana’s already approved work requirement. Powerful evidence from New Hampshire and Arkansas reinforce prior evidence that Medicaid work requirements lead to thousands of coverage losses (and no appreciable gains in employment). Rather than approving additional exemptions and other amendments, HHS should heed this evidence and withdraw fully its approval of Indiana’s work requirement before thousands more lose coverage.