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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- June 19, 2020
As part of its ongoing attacks on health care and civil rights, the Trump administration recently finalized drastic changes to regulations implementing Section 1557, the Affordable Care Act’s nondiscrimination provision. Section 1557 provides important protections against discrimination on the basis of race, color, national origin (including language access), sex, age, and disability. In the final rule, the administration seeks to roll back many of these protections. However, the administration cannot repeal a law through regulations. Persons who experience discrimination in health care programs or activities are still protected. This issue brief provides an overview of important changes to the Section 1557 implementing regulations, and how they may affect key populations. The final section shares how individuals who encounter health care discrimination can enforce their rights through administrative and judicial complaints.
- May 11, 2020
Following the release of Beyond the Law: The Challenge of Abortion Coverage in the Marketplaces, various state advocates and commercial plans asked the National Health Law Program for more detailed recommendations on how plans can improve abortion coverage and how they communicate such coverage to potential and current enrollees. In this Issue Brief, NHeLP suggests measures that states and insurers can take under existing legal requirements (advocates could seek to advance policies under both categories).
- May 11, 2020
Studies demonstrate that underserved populations—such as low-income, rural, and Medicaid populations—are not using telehealth as widely as other demographic groups. Long before the COVID-19 pandemic, states and providers had begun to develop innovative initiatives to address these disparities. NHeLP has prepared a list of principles that states should consider as they enact Medicaid policy on telehealth.