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
- Show all
- Alabama
- Alaska
- All United States
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- National
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
- November 29, 2023
NHeLP Federal Comments on California CalAIM 1115 Waiver Amendment Submission
In comments to HHS, NHeLP provides several policy considerations regarding California's proposals to add Transitional Rent as an "In Lieu of Service" that Medi-Cal managed care plans could offer to enrollees.
- December 22, 2022
An Advocate’s Guide to Medi-Cal Services
The National Health Law Program is pleased to present our updated 2022 Advocates Guide to Medi-Cal Services. NHeLP's Medi-Cal Services Guide, first released in 2020, provides an in-depth description of some of the most important services covered in the Medi-Cal program, including prescription drug services, mental health and substance use disorder services, reproductive and sexual health services, gender-affirming services, dental services, children services, among others. The 2022 updated guide focuses on key changes the Medi-Cal program has undergone in recent years. In particular, relevant chapters now emphasize policy changes implemented pursuant to the California Advancing and Innovating Medi-Cal (CalAIM) initiative, including a new chapter on Case Management and Community-Support Services, which provides insight on new services that have become widely available through implementation of CalAIM. There is also a new addendum summarizing Medi-Cal's telehealth policy in light of changes adopted during the COVID-19 pandemic. The entire guide can be downloaded or individual chapters accessed below.
- October 13, 2022
NHeLP Comments on California Section 1115 Demonstration Five-Year Renewal and Amendment Request: CalAIM Demonstration
In comments to HHS, NHeLP urges the Secretary to reject California's plan to renew its Institution for Mental Diseases (IMD) waiver for Medi-Cal beneficiaries with SUD. The comments emphasize concerns with flexibilities sought by the State to allow for longer stays at IMDs for both minors and adults. In addition, NHeLP's comments demonstrate support for several new services, such as peer support services, but caution that the use of a Section 1115 waiver instead of a state plan amendment is inappropriate. Finally, NHeLP urges both California and HHS to require all counties to participate in the expanded SUD program.
- January 30, 2014
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.
- July 29, 2013
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.
- July 23, 2013
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.
- July 23, 2013
1115-Copayment Waiver Amendment Attachments
For full publication text, download document.
- July 23, 2013
Duals Demonstration/Coordinated Care Initiative (CCI) As Amended by May Revise
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…
