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

results in Waivers and Demonstrations and California.
  • Continuity of Care in the LIHP Transition

    Continuity of Care (?COC?) is critical to the successful transition of Low Income Health Program (LIHP) enrollees into Medi-Cal managed care.

  • Comments on Draft Bridge Plan Demonstration Project

    NHeLP's comments on Covered California's proposal to use bridge plans to serve lower income people connected to Medi-Cal in the Exchange focus on ensuring that lower income people have timely access to affordable plans and continuity of care.

  • Due Process in California’s Early Medicaid Expansion Program

    Low-Income Health Programs (LIHP) were created in 2010 to allow California to expand health coverage to low-income individuals not otherwise eligible for Medicaid. This brief describes the notice and appeals rules in the LIHPs, and their implementation around the state.

  • 1115-Copayment Waiver Amendment Attachments

    For full publication text, download document.

  • Duals Demonstration/Coordinated Care Initiative (CCI) As Amended by May Revise

    Kim Lewis

    Honorable Members  California State Legislature  Re: Duals Demonstration/Coordinated Care Initiative (CCI) As Amended by May Revise ? Concerns  The undersigned organizations have been active participants in the planning process for the Duals Demonstration Project, which was authorized by SB 208 (Statutes of 2010) as pilot programs in up to four counties. We have also written to oppose the Governor?s State Budget Proposal which proposed to expand the demonstration from four to ten counties as part of the Coordinated Care Initiative (CCI). In early May, several of our organizations individually gave input to the Department of Health Care Services (DHCS) and Department of Social Services (DSS) on our outstanding concerns regarding the State?s draft plan to the Centers for Medicare and Medicaid Services (CMS).  We continue to work collaboratively with the Administration and hope to see a demonstration which delivers on the potential for integrated funding and services for people who are dually eligible for Medi-Cal and Medicare. While we appreciate the proposed changes in the May Revision to delay implementation from January 1, 2013 to March 1, 2013 and to reduce the proposed expansion of pilots to eight counties, we must continue to oppose…

Load More