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 13, 2020
On May 12, 2020, Democrats in the House of Representatives introduced the HEROES Act (Health and Economic Recovery Omnibus Emergency Solutions Act) to address the continuing economic fallout of the COVID-19 pandemic. Medicaid has always served as the safety net for low-income and underserved individuals, providing comprehensive, affordable health care. The HEROES Act includes a number of provisions that would help ensure Medicaid remains robust. The following provides a brief summary of the major Medicaid-related provisions in the HEROES Act. As we continue to fight both the pandemic and its resulting economic consequences, Medicaid needs to remain steadfast, strong, and available to the millions who already rely on the program and the millions more who likely will become eligible as the pandemic continues.
- 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.