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. 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.

  • Schwartz v. Cal DHCS, Superior Court of California

    Abbi Coursolle and

    An adult California Medicaid (Medi-Cal) beneficiary is challenging the California Department of Health Care Services and her county Mental Health Plan after she experienced a mental health crisis and was turned away from evaluation and subsequent treatment without appropriate notice. The Plaintiff alleges that she was denied medically necessary specialty mental health services when she critically needed them and was forced to pay for the care she needed out-of-pocket.

  • Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California

    The National Health Law Program’s Doula Medicaid Project seeks to improve health outcomes for pregnant Medicaid enrollees by ensuring that all pregnant individuals enrolled in Medicaid who want access to a doula will have one. As part of this project, the National Health Law Program is proud to publish our report Building A Successful Program For Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California. This report is the distillation of a survey of doulas across California, as well as a series of focus groups held at four locations across the state. Based on the input of the doulas who responded to the survey and participated in the focus groups, the report concludes with a series of recommendations for how to go about creating an equitable, inclusive, and sustainable program for Medi-Cal coverage for doula care here in California. As states across the country have moved to introduce legislation relating to Medicaid coverage for doula care, we want to make sure that any such efforts prioritize the input of doulas and their experience. We hope that this report provides doulas, advocates, agencies, and other stakeholders with the information and insight needed to expand access to…

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