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 California.
  • Katie A. v. Los Angeles County, Central District of California/Western Division

    Litigation Team

    Katie A. v. Bonta is a class action lawsuit that was filed in July 2002 against California’s State Departments of Health Care Services and Social Services (the state case), as well as Los Angeles County and its child welfare agency (the county case). It challenges the State and County’s failure to provide necessary home-based and community-based mental health services to children who are in or at risk of foster care. A settlement agreement with Los Angeles County was reached in 2003 wherein the County agreed to close its large shelter facility for foster youth - MacLaren Children’s Center - and to develop appropriate child welfare and mental health services in the community. An expert Advisory Panel was established as part of the settlement agreement to monitor implementation and assist the County. While one lawsuit was filed against both the State and LA County, this part of the case is known as Katie A. v. Los Angeles County.   In 2019 the County moved to end the agreement and dismiss the litigation. In September 2020, a new settlement agreement was reached between the parties. The new agreement requires by the County to take specific steps over a period of approximately…

  • Amicus: State of N.Y., et al. v. U.S. Dep’t Health & Human Servs., Southern District of New York

    Litigation Team

    National Health Law Program (NHeLP), Justice in Aging, and the Disability Rights Education and Defense Fund (DREDF) submitted an amicus brief in the Southern District of New York on behalf of themselves and 47 partners. The brief supports the State of New York and 22 other states’ motion for partial summary judgment against implementation of the Trump administration’s recently finalized rule to restrict the reach of Section 1557, the Affordable Care Act’s ground-breaking anti-discrimination provision. Our amicus argues that this Trump administration rule ignores the plain language of the ACA and is an arbitrary and capricious action by the administration. The 2020 changes to the 2016 Section 1557 rule include sharply limiting what entities must comply with Section 1557; eliminating notice, tagline, and effective communication requirements; and incorporating harmful exemptions from statutes not listed in the ACA, including religious exemptions. The Trump administration’s changes to the Section 1557 rule harm the very people that the ACA was intended to protect and removes critical protections that will impact millions of women, LGBTQ+ individuals, older adults, Black, Indigenous, and people of color (BIPOC), and individuals with limited English proficiency (LEP). The case in SDNY is one of several cases challenging the rule.

  • Katie A. v. Bonta, U.S. District Court for the Central District of California

    Litigation Team

    Katie A. v. Bonta is a class action lawsuit that was filed in July 2002 against California’s State Departments of Health Care Services and Social Services (the state case), as well as Los Angeles County and its child welfare agency (the county case). It challenges California’s failure to provide home-based and community-based mental health services to children who are in or at risk of foster care. A settlement agreement was reached in the state case in 2011 while the county case (Katie A. v Los Angeles County) reached a separate settlement agreement. The settlement required the state to make “intensive care coordination, intensive home based services, and therapeutic foster care available to children on Medi-Cal with mental health needs, to enable them to stay in their own homes and communities.

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