Waivers
Section 1115 of the Social Security Act establishes authority for the Secretary of Health and Human Services (HHS) to waive certain provisions of the Medicaid and CHIP statutes for a state to establish an “experimental, pilot or demonstration” project that promotes the objectives of the program. Such demonstrations are intended to test and learn about new approaches to program design and administration. States have obtained Section 1115 waivers that make broad changes in Medicaid eligibility, benefits, cost sharing, and delivery and payment of care.
Medicaid Work Requirements: News from the Litigation Front
It has been obvious for several months that the wheels have come off the Medicaid work requirements bus. The Secretary of HHS has approved “demonstrations” of work requirements in nine states; none of these states is currently implementing. And no state that accepts the 6.2 percentage point increase in its federal Medicaid matching rate made […]
States Should Reevaluate Harmful Medicaid Waivers to Respond to COVID-19
To respond to the COVID-19 crisis, many states have made significant, temporary changes to their Medicaid programs, mostly through emergency waivers and state plan amendments. However, states also have the option to make more lasting changes by reversing harmful policies in their Section 1115 waivers. Unwinding bad waivers not only makes it easier for states, […]
COVID-19 Medicaid Waiver Soup Explained
Over the past month there has been an explosion of Medicaid waiver activity relating to the COVID-19 pandemic. This activity is not to be confused with the implosion of the Medicaid section 1115 work requirements waivers, which would undermine coverage. Instead, the COVID-related waivers are designed to help state Medicaid programs respond to the pandemic, […]
Pandemic Induced Pragmatism: The State of Medicaid Waiver Policy
Amongst other ways in which life has dramatically changed in the last month, Section 1115 Medicaid waiver terrain has experienced a tectonic shift. For those of us who have been responding to massive numbers of public comment periods over the past two-plus years, only one waiver opened for public comment that we are commenting on […]
Indiana’s Own Medicaid Waiver Evaluation Shows Evidence of Coverage Losses
Indiana’s Healthy Indiana Plan (HIP) demonstration, which has been approved in its current form since January 2015, has its extension application up for federal comment. If approved as is, the demonstration would be allowed to continue ten for years! The current HIP demonstration includes work requirements, a tiered benefit structure based on payment of monthly […]
Florida House Bill Targeting Parents on Medicaid Would Cause Huge Coverage Losses
Florida’s legislature is at it again, despite a recent strong Appeals Court ruling that Medicaid work requirements are not permitted by the statute. A bill to impose the harshest Medicaid work reporting requirements in the country on very poor parents – mostly women – is moving through Florida’s House of Representatives. An identical bill passed […]