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.
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- July 23, 2013
Joel Ferber, Legal Services of Eastern Missouri On June 28, 2012, the Supreme Court upheld the controversial ?individual mandate? and the constitutionality of the Affordable Care Act (ACA).1 The Court, however, did what no district or appellate court had done - finding that the ACA?s provision allowing the federal government to remove all federal Medicaid funding for states that do not expand coverage to 133% of the federal poverty level was unconstitutional, even though the expansion itself is constitutional.2 The Court treated the ACA?s expansion of the Medicaid program as if it were a new program and decided the federal government could not condition funds for the existing Medicaid program on participation in the ?new program? created by the ACA. This ruling did not actually make the Medicaid expansion an ?optional? program for states, but will likely have the same effect by stripping the Secretary of HHS of meaningful enforcement authority to require states to implement the ACA?s mandatory expansion. This decision means that many states, including Missouri, are going to treat the expansion as if it were a state option. Such action is very significant since more than half of the uninsured individuals projected to receive coverage…
- July 23, 2013
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