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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- March 20, 2019
On November 30, 2018, the Department of Health and Human Services (HHS) approved New Hampshire’s request to condition Medicaid coverage of medically necessary services needed by low-income adults on work requirements and to waive retroactive coverage. The project is called “Granite Advantage.” Because Granite Advantage violates numerous provisions of federal law and will gravely harm tens of thousands of New Hampshire residents, the National Health Law Program (NHeLP) and co-counsel New Hampshire Legal Assistance and National Center for Law and Economic Justice filed a lawsuit challenging the approval on March 20, 2019.New Hampshire is currently implementing the approved waiver. Retroactive coverage ended on January 1, 2019. Individuals must begin completing work activities in June 2019, and could lose their coverage due to noncompliance beginning August 1, 2019.The class action lawsuit was filed on behalf of four individuals who currently obtain their health care through Medicaid and will suffer serious harms under Granite Advantage. Below are descriptions of how NH Granite Advantage will affect the named plaintiffs: Samuel Philbrick is 26 years old and lives in Henniker with his mother and father. Mr. Philbrick currently works as a cashier in a sporting goods store where he makes $11.33 per hour.…