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 Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Rhode Island
- South Carolina
- South Dakota
- West Virginia
- October 26, 2018
In comments to the U.S. Department of Health and Human Services, the National Health Law Program urges the department to reject Michigan’s Sec. 1115 Medicaid waiver application, because it would increase premiums and impose unlawful conditions of eligibility, including required healthy behavior and work-related activities. In previous comments to HHS, the National Health Law Program has detailed why even the existing premiums and cost sharing structure decrease enrollment and access to care and should not have been approved. Subsequent evidence has shown that the existing premiums and healthy behavior policies are increasing medical debt and depressing enrollment. The proposed changes will only exacerbate these problems. Additionally, the proposed changes do not comply with § 1115 of the Social Security Act, as they will block, rather than facilitate, access to Medicaid coverage.
- July 23, 2013
For full publication text, download document.