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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  • Medicaid Coverage of Family Planning Services 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. Almost nine months into the pandemic, millions of people have accessed services via telehealth. However, the need and desire for telehealth will persist after the public health emergency ends, particularly for individuals seeking time-sensitive reproductive and sexual health care. This fact sheet will address Medicaid coverage of family planning services delivered via telehealth.

  • Sec. 1115 Waiver Tracking Chart

    Sec. 1115 of the Social Security Act allows the Secretary of HHS to waive some requirements of the Medicaid Act so that states can test novel approaches to improving medical assistance for low-income people. While historically states have proposed waivers that did indeed propose innovative approaches to improve Medicaid and expand coverage, now, at HHS’s urging, several states are seeking waivers to impose harmful cuts and restrictions. The first set of harmful waivers have been approved for Kentucky, with a number of state’s poised to enact similar changes to Medicaid. This chart provides an overview of the harmful waiver provisions that have been proposed to-date. (Chart updated as of December 14, 2020)  

  • 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.

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