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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- July 23, 2013
The Supreme Court ruled in June that the new health reform law permits, rather than requires, states to expand their Medicaid programs to cover people with incomes up to 138 percent of the federal poverty line. Now, Tennessee must choose whether to expand Medicaid (TennCare). Some have argued that Medicaid expansion is too expensive. In fact, Medicaid expansion will not significantly increase costs for the state and will generate significant new tax revenues that will offset much or all of any additional costs through 2020. Tennessee requires all health maintenance organizations (HMOs) doing business in Tennessee to pay a 5.5% tax on all premium dollars collected from or on behalf of enrollees. Because all Medicaid enrollees in Tennessee are enrolled in HMOs (generally called Managed Care Organizations, or MCOs, in the TennCare context), Tennessee receives tax payments from TennCare MCOs from the premiums they collect on behalf of TennCare enrollees. If Tennessee decides to expand Medicaid, the federal government will pick up all of the cost of the expansion for the first three years (2014-2016). Depending on the number of newly eligible individuals who enroll in the first three years, this could bring between $1.5…
- July 23, 2013
Whereas, the separation of powers, both between the branches of the federal government and between federal and state authority, is essential to the preservation of individual liberty; Whereas, the Constitution creates a federal government of limited and enumerated powers, and reserves to the States or to the people those powers not granted to the federal government; Whereas, the federal government has enacted many laws that have preempted state laws with respect to Health Care, even though Health Care regulation is properly the authority and responsibility of the States; Whereas, the Member States seek to increase individual liberty and control over personal Health Care decisions, and believe the best method to secure that control is by vesting regulatory authority over Health Care in the States; Whereas, by acting in concert, the Member States may express and inspire confidence in the ability of each Member State to effectively govern Health Care; and Whereas, the Member States recognize that consent of Congress may be more easily secured if the Member States collectively seek consent through an interstate compact; NOW THEREFORE, the Member States hereto resolve, and by the adoption into law under their respective state…
- July 23, 2013
Nashville Public Radio reports on state lawmakers 2011 attempts to join Tennessee with other states in a ñcompactî to oppose the federal health care overhaul.