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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- District of Columbia
- New Hampshire
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- New Mexico
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- South Dakota
- West Virginia
- November 19, 2019
After finding that several states violated federal policy requiring reporting waivers in cases of rape, NHeLP partnered with state advocates to institute those waivers when Medicaid enrollees seek abortion coverage. One such state is Arizona. The National Health Law Program is pleased to release its most recent fact sheet, Medicaid Coverage of Abortion in Arizona, reflecting the inclusion of such waiver. This fact sheet provides an overview of how Medicaid in Arizona covers abortion under the circumstances allowed by federal and Arizona’s state law. It also explains the process providers must follow to seek reimbursement for abortions and includes the forms necessary to secure prior authorization and coverage. This is the first in a series to ensure providers and funds are aware of the changes, and that patients are covered by Medicaid.
- July 23, 2013
William E. Morris Institute for Justice comments on Arizona 1115 Waiver --------------------------------------------------- For full publication text, download document.
- July 23, 2013
This paper describes the decision by HHS did not approve a request to waive the maintenance of effort requirement for Arizona, but did discuss waiver authority.