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
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- District of Columbia
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- South Dakota
- West Virginia
- April 3, 2020
This webinar explores the different options states can use to modify their Medicaid programs to meet people's needs under the COVID-19 pandemic. It covers how states can use Section 1135 and 1115 waivers, state plan amendments, 1915(c) Appendix K, and Section 6008 (FMAP) to improve access to care and services. It also includes trends from current state activities and advocacy recommendations. The accompanying slideshow can be accessed here.
- April 3, 2020
In this video, NHeLP's Director of Health Policy, Leo Cuello, discusses ways that advocates can use Medicaid's 1135 waivers to help shape their state's response to the COVID-19 pandemic. You can also visit our Coronavirus Resources Page for additional COVID-19 related information at Coronavirus Resources
- April 2, 2020
Over the past few weeks, Congress has passed several laws in response to the coronavirus pandemic. This fact sheet summarizes the provisions of these laws that affect Medicaid. The laws include many important policies to ensure individuals have the health care coverage they need during the pandemic– including enhanced federal Medicaid funding, provisions to ensure states do not disenroll Medicaid enrollees or make the enrollment process more difficult, and an option to cover COVID-19 testing for individuals who are uninsured. However, there is still significantly more to do.