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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- January 6, 2021
Meeting the Moment: Understanding EPSDT and Improving Implementation in California to Address Growing Mental Health Needs
Children and youth across the country are facing an escalating mental health crisis. The events of 2020 have added new and complex stressors, exacerbating mental health challenges while also creating new barriers to accessing care. Unmet mental health needs have grave consequences for individuals, their families, and entire communities. Now more than ever, it is crucial that we have robust, well-functioning systems in place to identify and respond to children’s needs early, effectively, and equitably. Our "Meeting the Moment" paper is essential reading for anyone interested and engaged in supporting and protecting the health and welfare of children in California. This paper purposefully packs in a lot. It includes more than 150 source citations and fully and faithfully tracks the winding and inconsistent interpretation of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) entitlement in California with a particular focus on the support for the social, emotional, and behavioral health of children in Medi-Cal.
- December 23, 2020
This fact sheet discusses access to care through California Children’s Services during COVID-19.
- December 23, 2020
The COVID-19 public health emergency (PHE) has fundamentally altered how California’s Medi-Cal program is administered. At the start of the pandemic, the state worked swiftly to seek waivers and other flexibilities of federal Medicaid requirements and to implement these COVID-19 flexibilities, including significant changes intended to streamline Medi-Cal eligibility and enrollment. In order to preserve Medi-Cal coverage for low-income Californians once the pandemic ends, California’s Medicaid agency, the Department of Health Care Services (DHCS), needs to plan now for its end. This issue brief highlights various policies the state put in place during the pandemic that should be continued after the pandemic, as well as other policies it needs to put in place now to mitigate harm to the Medi-Cal population once the pandemic is over. This brief is part of NHeLP’s California Policy Needs During COVID and Beyond series. Additional entries include: California Policy Needs During COVID and Beyond: Telehealth California Policy Needs During COVID and Beyond: Reproductive and Sexual Health California Policy Needs During COVID and Beyond: Due Process