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

  • A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment: 2021 Update

    A Quick and Easy Method of Screening for Medicaid Eligibility under the Pickle Amendment: 2021 Update" is a screening tool and chart, originally created by Gordon Bonneyman of the Tennesee Justice Center and updated by NHeLP, to determine if clients may be Medicaid eligible under the Pickle Amendment. The screening process will eliminate the great majority of those who are not eligible without the necessity of performing any mathematical calculations.

  • Testimony on the Hyde Amendment before the House Subcommittee on Labor, Health and Human Services, Education, and Related Agencies

    The National Health Law Program (NHeLP) submitted this testimony to the House Committee on Appropriations’ Subcommittee on Labor, Health and Human Services, Education, and Related Agencies' hearing on "The Impact on Women Seeking an Abortion but are Denied Because of an Inability to Pay." We advocate for Medicaid policies and laws from coast to coast that meet the needs of low-income individuals and others who face systems of oppression that harm their health, such as women; Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Gender Non-conforming (LGBTQI-GNC) people; Black, Indigenous, People of Color (BIPOC); immigrants; and people with disabilities. We also protect and enforce the rights of Medicaid enrollees in the courts. We also advocate for a seamless system of comprehensive, quality, and affordable health care that includes the full spectrum of reproductive and sexual health services. That spectrum includes family planning and pregnancy-related care, including abortion, an essential health care service. We apply a reproductive justice framework in our advocacy and analysis, exposing and fighting the systems of oppression that affect a person’s ability to make health decisions about their body, sexuality, health, and reproductive future. NHeLP’s testimony for this hearing addresses how the Hyde Amendment’s de facto ban…

  • NHeLP Comments on HHS Regulations Rule (aka SUNSET Rule)

    In the Regulations Rule, HHS seeks to retroactively impose a mandatory expiration date on an estimated 18,000 duly promulgated regulations. Even long-standing rules would be automatically rescinded unless they survive a complex process of assessment and review. Programs like Medicaid and the Children's Health Insurance Program (CHIP) could be devastated if important regulations are arbitrarily rescinded. In comments, NHeLP pushes back against this unlawful and ill-conceived proposal designed to sabotage HHS safety net programs.

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