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

  • Medicaid Coverage of Medication Abortion Delivered via Telehealth

    The COVID-19 public health emergency has shown the need to increase access to health services through telehealth, including for Medicaid beneficiaries. A year into the pandemic, millions of people have accessed services via telehealth. The need and desire for telehealth will persist after the pandemic ends, particularly for individuals seeking time-sensitive reproductive and sexual health care including abortions. The American College of Obstetricians and Gynecologists (ACOG) encourages all providers to strategize how they could integrate telehealth into their services since the use of telehealth can increase abortion access.

  • Wright v. AHCA, Second Judicial Circuit in and for Leon County, Florida

    Litigation Team

    Plaintiff Nancy Wright is a Florida attorney who has represented hundreds of Florida Medicaid recipients (often pro bono) who are challenging erroneous terminations, denials, or reduction of Medicaid benefits. To prepare these appeals, Attorney Wright needs to access the state Medicaid agency’s (Agency for Health Care Administration's or AHCA’s) fair hearing orders. Florida law requires the orders be available free of charge from a searchable electronic database. However, AHCA denies that it is required to do so and insists on charging for these orders.  Wright has filed suit to compel the agency to comply with the Florida law requiring posting.

  • NHeLP Comments to Arizona AHCCCS Extension Application (2021)

    NHeLP comments opposing work requirements and other harmful proposals in Arizona's Health Care Cost Containment System section 1115 extension application.

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