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

results in New Mexico.
  • Amicus: State of N.Y., et al. v. U.S. Dep’t Health & Human Servs., Southern District of New York

    Litigation Team

    National Health Law Program (NHeLP), Justice in Aging, and the Disability Rights Education and Defense Fund (DREDF) submitted an amicus brief in the Southern District of New York on behalf of themselves and 47 partners. The brief supports the State of New York and 22 other states’ motion for partial summary judgment against implementation of the Trump administration’s recently finalized rule to restrict the reach of Section 1557, the Affordable Care Act’s ground-breaking anti-discrimination provision. Our amicus argues that this Trump administration rule ignores the plain language of the ACA and is an arbitrary and capricious action by the administration. The 2020 changes to the 2016 Section 1557 rule include sharply limiting what entities must comply with Section 1557; eliminating notice, tagline, and effective communication requirements; and incorporating harmful exemptions from statutes not listed in the ACA, including religious exemptions. The Trump administration’s changes to the Section 1557 rule harm the very people that the ACA was intended to protect and removes critical protections that will impact millions of women, LGBTQ+ individuals, older adults, Black, Indigenous, and people of color (BIPOC), and individuals with limited English proficiency (LEP). The case in SDNY is one of several cases challenging the rule.

  • NM Letter to Gov Martinez Urging Medicaid expansion

    External Source

    Letter to New Mexico Governor Susana Martinez urging the implementation of the Medicaid Expansion program.     --------------------------------------------------- For full publication text, download document.  

  • The Medicaid Opportunity in New Mexico: Frequently Asked Questions

    External Source

    Doesn?t Medicaid already cover the poorest New Mexicans?   No. Most low-income adults cannot qualify for Medicaid right now. Medicaid covers some low-income New Mexicans already: children, pregnant women, people with disabilities, elderly people, and extremely lowincome parents. But most low-income adults can?t qualify for Medicaid now no matter how low their income level ? many adults who are living in poverty do not qualify for Medicaid, and parents who work ? even if they earn minimum wage ? typically make too much money to qualify. The Medicaid Opportunity would provide coverage to over 170,000 uninsured New Mexicans with incomes below 138% of the federal poverty level ? about $15,000 for an individual and $32,000 for a family of 4. New Mexico currently has the second highest rate of uninsured people in the nation. This is our chance to change that. Will the Medicaid Opportunity cost $500 million between now and 2020?   No. In fact, the state makes money in the first seven years. The federal government pays the entire costs for three years. After that, the state must start contributing (5% in 2017, 6% in 2018, 7% in 2019, and then 10%…

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