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 North Carolina.
  • Putting Medicaid to Work for Juvenile Justice

    This presentation for the Juvenile Defenders Conference in North Carolina provides information on the health status of individuals in the juvenile justice system and details on the limitations of Medicaid eligibility while in detention. It also includes descriptions of NC Medicaid and CHIP eligibility rules, services covered, and due process requirements.

  • Fourth Circuit Allows Medicaid Case to Proceed

    On May 9th, the Fourth Circuit Court of Appeals became the first circuit court to decide a novel set of sovereign immunity issues that are being raised in three other federal circuit courts.  The case, Antrican v. Odom, was a unanimous decision written by Judge Niemeyer. See 2002 U.S.App. LEXIS 8910.   Antrican involves Medicaid-eligible children in North Carolina who have been unable to obtain dental services as the Medicaid Act requires, due in large part to a lack of Medicaid-participating dentists.  The children also claim that the Medicaid provisions for Early and Periodic Screening, Diagnosis and Treatment (EPSDT) are being violated.   After District Judge Malcolm Howard rejected the state?s motion to dismiss, the State Attorney General appealed the decision to the Fourth Circuit.  There, the state raised a number of sovereign immunity claims seeking to bar plaintiffs? from obtaining injunctive relief pursuant to the Ex parte Young exception to the Eleventh Amendment.  Significantly, they argued that private individuals can never enforce the Medicaid Act or any other spending clause enactment.   The Fourth Circuit rejected each of the Attorney General?s arguments. The Court also refused to exercise pendent jurisdiction over…

  • Antrican v. Odom – Text of the Decision

    External Source

    Decision in EPSDT dental case

Load More