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

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  • Sec. 1115 Waiver Tracking Chart

    Sec. 1115 of the Social Security Act allows the Secretary of HHS to waive some requirements of the Medicaid Act so that states can test novel approaches to improving medical assistance for low-income people. While historically states have proposed waivers that did indeed propose innovative approaches to improve Medicaid and expand coverage, now, at HHS’s urging, several states are seeking waivers to impose harmful cuts and restrictions. The first set of harmful waivers have been approved for Kentucky, with a number of state’s poised to enact similar changes to Medicaid. This chart provides an overview of the harmful waiver provisions that have been proposed to-date. (Chart updated as of August 17, 2020)  

  • Contraceptive Equity in Action: A Toolkit for State Implementation

    The National Health Law Program is dedicated to ensuring appropriate implementation and monitoring for states that have adopted Contraceptive Equity laws. The National Health Law Program developed this Toolkit to explain how Contraceptive Equity laws fit within the broader federal and state health insurance landscape. After laying out the federal legal framework for contraceptive coverage laws, the Toolkit provides a comprehensive analysis of the laws in all states that have adopted Contraceptive Equity. It then delves into specific tips and strategies for a range of stakeholders relevant to contraceptive coverage: advocates, media and communications strategists, providers, health plans, and regulators. It concludes with a series of practical tools in the Appendices, such as a model formulary, a 50-state survey detailing which states have implemented Contraceptive Equity mandates, and template violations and appeals letters (Updated July, 2019).

  • National Health Law Program Amicus Brief, Title X Final Rule Challenges

    Court Cases On March 4, 2019 the Trump Administration announced a new final regulation change to the Title X Family Planning Program. The new rule significantly curtails access to comprehensive family planning services, and disproportionately impacts low-income individuals and people of color. Title X is an extremely impactful federal program designed to provide affordable birth control and reproductive health care for low-income individuals, and to ensure they can make informed decisions about their reproductive decisions. The new rule effectively bars reproductive health clinics that provide abortion care or provide referrals for such care from participating in Title X. It also makes it significantly easier for Federal funds to be diverted from reproductive health care providers to medically-dubious, anti-abortion, faith-based care providers. Immediately after the final rule was announced, 21 states filed suit against Alex Azar, the Secretary of Health and Human Services, for the approval of this new rule, citing in their Complaint the “burdensome and unnecessary restrictions” to care that the rule created. The Plaintiffs argue that the rule also “undermine Congress’s intent in enacting Title X of the Public Health Services Act nearly five decades ago.” Brief of Amici Curiae This Amicus Brief was filed on July…

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