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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  • Section 1115 Waiver in Indiana: Effects on People with Disabilities

    Earlier today, HHS approved a section 1115 waiver requested by Indiana. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people with disabilities. Though Indiana sells its proposal as primarily affecting childless, unemployed adults, many of the approved provisions will impact everyone in the expansion group, including people with disabilities. This fact sheet describes that impact.

  • Indiana’s Section 1115 Medicaid Waiver & Its Impact on Health Equity

    Earlier today, HHS approved a section 1115 waiver requested by Indiana. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people of color, women, and people with disabilities. This fact sheet describes that impact.

  • 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 June 10, 2018)

  • Summary of Lawsuit Filed Against HHS Approval of Kentucky Waivers

    On January 12, 2018 the Department of Health and Human Services (HHS) approved numerous section 1115 waivers in Kentucky (KY Waivers). Because the approvals violate numerous provisions of law and will gravely harm hundreds of thousands of Kentuckians, the National Health Law Program (NHeLP) brought a lawsuit challenging them on January 24, 2018. NHeLP brought the lawsuit together with the Kentucky Equal Justice Center and the Southern Poverty Law Center. This summary lays out the basics of the lawsuit, the legal claims, as well as next steps for the litigation.

  • Stewart v. Hargan, Lawsuit Challenging Kentucky Medicaid Waiver Project

    Representing 15 Medicaid beneficiaries in Kentucky, the National Health Law Program (NHeLP), the Kentucky Equal Justice Center (KEJC), and the Southern Poverty Law Center (SPLC) sued the Trump administration today in federal court for its approval of a state Medicaid waiver project that will cause nearly 100,000 hard-working Kentuckians to lose health care coverage.  "Through imposition of premiums and cost sharing, 'lockouts,' benefits cuts, and a work requirement, the waiver will radically reshape Medicaid in a manner that, by the State's own admission, will result in substantial reductions in coverage."

  • HHS Approves Harmful 1115 Waivers in Kentucky

    Leo Cuello and

    Earlier today, HHS approved the "Kentucky HEALTH" section 1115 waiver. The approval allows Kentucky to ignore numerous critical and long-standing Medicaid protections for eligible Kentuckians. The approved project is effectively a health care cut that will worsen or eliminate access to Medicaid for low-income individuals. It is a huge step backwards for Kentucky's Medicaid expansion, which had been held out as a national model.

  • Harmful Section 1115 Waiver in Kentucky: Effects on People with Disabilities

    Earlier today, HHS approved a section 1115 waiver requested by Kentucky. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people with disabilities. Though Kentucky sells its proposal as primarily affecting childless, unemployed adults, many of the approved provisions will impact everyone in the expansion group, including people with disabilities. This fact sheet describes that impact.

  • HHS Approves 1115 Waiver in Kentucky – Harming Medicaid Enrollees Who Need Reproductive Health Services

    Earlier today, HHS approved a section 1115 waiver requested by Kentucky. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant, detrimental impact on low-income individuals, particularly women, seeking reproductive health care. This fact sheet describes that impact.

  • Kentucky’s Section 1115 Medicaid Waiver and Its Impact on Health Equity

    Earlier today, HHS approved a section 1115 waiver requested by Kentucky. The approved project is effectively a cut that will worsen or eliminate access to Medicaid for low-income individuals. This proposal will have a significant detrimental impact on people of color, women, and people with disabilities. This fact sheet describes that impact.

  • NHeLP Letter to CMS Regarding Work Requirements

    In an unprecedented move, HHS issued a letter announcing its intention to approve state requests to impose work requirements on Medicaid enrollees. NHeLP responded swiftly, submitting a letter to the Centers for Medicare & Medicaid Services (CMS), explaining why the radical shift in Medicaid policy is procedurally and substantively flawed. Further, the few studies CMS cites to support work requirements do not backup CMS's conclusion that any and all work produces positive health outcomes.

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