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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- July 20, 2020
NHeLP comments on Medicaid Prescrption Drug Rebate Program and Value- based Purchasing Proposed Rulemaking
In a proposed rule, CMS seeks to expand value-based purchasing arrangements for prescription drugs in commercial plans and the Medicaid program. However, the proposed changes offer a cost-containment strategy with no safeguards to ensure that Medicaid enrollees can continue to access needed outpatient prescription drugs. NHeLP comments warn against“cost effectiveness” measures which are discriminatory or lead to unlawful health care rationing, and urge CMS to withdraw the proposed rule.
- July 16, 2020
On June 29th, the Supreme Court ruled in June Medical Services vs. Russo that Louisiana’s admitting privileges law is unconstitutional and blocked it from taking effect. This win for reproductive health advocates means that abortion clinics can remain open to serve patients who need abortion care in Louisiana and in several other states where similar laws have been enacted. Advocates for reproductive health, rights, and justice, including the National Health Law Program, are relieved by the decision, but we also know that we must do more work to expand abortion access for individuals who are low-income, BIPOC, as well as LGTBQ-GNC. Today and always, abortion is essential, time-sensitive health care that is constitutionally protected but not as accessible as it should be.