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

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  • Access to Care Through California Children’s Services During COVID-19

    This fact sheet discusses access to care through California Children’s Services during COVID-19.

  • California Policy Needs During and After COVID: Eligibility, Enrollment, and Retention

    The COVID-19 public health emergency (PHE) has fundamentally altered how California’s Medi-Cal program is administered. At the start of the pandemic, the state worked swiftly to seek waivers and other flexibilities of federal Medicaid requirements and to implement these COVID-19 flexibilities, including significant changes intended to streamline Medi-Cal eligibility and enrollment. In order to preserve Medi-Cal coverage for low-income Californians once the pandemic ends, California’s Medicaid agency, the Department of Health Care Services (DHCS), needs to plan now for its end. This issue brief highlights various policies the state put in place during the pandemic that should be continued after the pandemic, as well as other policies it needs to put in place now to mitigate harm to the Medi-Cal population once the pandemic is over. This brief is part of NHeLP’s California Policy Needs During COVID and Beyond series. Additional entries include: California Policy Needs During COVID and Beyond: Telehealth California Policy Needs During COVID and Beyond: Reproductive and Sexual Health  California Policy Needs During COVID and Beyond: Due Process

  • Comments to Georgia 1332 Application

    NHeLP comments to GA 1332 application attempting to privatize Marketplace.

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