Background to Medicaid and Section 1115 of the Social Security Act

Executive Summary

Health and Human Services (HHS) Secretary Tom Price has signaled a willingness to allow states to reshape their Medicaid programs. In this issue brief, Legal Director Jane Perkins provides a background to Medicaid and Section 1115 of the Social Security Act to explain what HHS and the states are permitted to do in regards to providing Medicaid services. Perkins concludes that Section 1115 “allows states to test novel approaches to providing medical assistance,” but does not allow HHS or the states to “ignore congressional mandates; to cut eligibility, services, or provider payments; or to use section 1115 to save money.”