Waiver 1115 Information

In August, 2001, the Centers for Medicare and Medicaid Services (CMS) announced the Health Insurance Flexibility and Accountability (HIFA) Demonstration Initiative.  HIFA encourages states to seek waivers of various provisions of the Medicaid Act and the State Children?s Health Insurance Program (SCHIP) to expand basic health insurance coverage to groups not currently eligible to receive benefits.  In return, CMS has promised the states fast-track consideration of their waiver requests.      However, CMS has also required that a state?s resulting waiver program, with the expansion in coverage contemplated by HIFA, must not cost the federal government any more money over the life of the waiver than it would have paid without the waiver.  In this time of state budget stress, it is likely that this budget neutrality requirement will result in significant benefit cuts for those already receiving assistance, cost-sharing requirements beyond those authorized by the statute (in a provision that is not properly subject to waiver), and/or the imposition of enrollment caps and waiting lists in Medicaid.    HIFA divides Medicaid and SCHIP recipients into three groups:  mandatory, optional, and expansion.   Those in mandatory groups (see Mandatory vs. Optional Eligibility in Medicaid)…