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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… results in Waivers and Demonstrations and Alabama.
  • April 27, 2021

    Alabama Section 1115 Institutions for Mental Disease Waiver for Serious Mental Illness Comments

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    In comments to the Department of Health and Human Services, the National Health Law Program urges HHS to reject Alabama’s proposed request to waive the Institutions for Mental Diseases (IMD) exclusion. First, the Secretary may only waive requirements of the federal Medicaid Act to conduct an experiment or test a novel approach to improve medical assistance for low-income individuals, and Alabama has not proposed a genuine experiment or novel approach. Second, Alabama asks the Secretary to waive provisions of the Medicaid Act the Secretary does not have the authority to waive. Section 1115 only permits the waiver of those requirements found in 42 U.S.C. § 1396a, and Alabama requests a waiver of provisions outside of 42 U.S.C. § 1396a, including the “Institution for Mental Diseases” (IMD) exclusion. Third, Alabama’s proposal risks diverting funds away from community-based services, undermining decades of progress toward increased community integration. Last, Alabama proposes several reforms that simply do not require any wavier of the Medicaid Act. Such reforms should be pursued outside of the context of a waiver.

  • February 1, 2019

    The Personal Stories of Those Affected by Arkansas’ Sec. 1115 Waiver

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    National Health Law Program Attorneys Mara Youdelman and Elizabeth Edwards detail stories of individuals in Arkansas who are being harmed by the state's Medicaid work requirement.

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