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
- District of Columbia
- New Hampshire
- New Mexico
- New York
- North Carolina
- August 15, 2018
National Health Law Program in comments to the U.S. Department of Health and Human Services urges the agency to reject portions of Maine's Sec. 1115 Medicaid waiver plan called "Health Care Reform Demonstration for Individuals with HIV/AIDS," because they run afoul of the HHS Secretary's authority to waive certain requirements of Medicaid. Maine's waiver project, as National Health Law Program notes in its comments, seeks to limit the scope of Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT), and to continue using an outdated measure for monitoring the effectiveness of HIV care. Regarding the Maine Medicaid waiver's attempt to limit EPSDT, National Health Law Program states in its comments, "Children living with HIV/AIDS are highly vulnerable and can have complex medical needs, imposing arbitrary limits on Medicaid services prevents these children from obtaining necessary care and is contrary to federal law."