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.
Advancing Postpartum Coverage in Medicaid: Waiver or SPA?
The recently enacted American Rescue Plan Act has many new opportunities and important provisions that we are still absorbing and unpacking. One key change, as readers of SayAhh! know, is the new state option to provide 12 months of postpartum Medicaid and CHIP coverage to women after the end of their pregnancy, well beyond the […]
Some States’ Letters to CMS on Medicaid Work Requirements Double Down
Last month, CMS began taking steps to get rid of Medicaid section 1115 work requirement waivers as my colleague Joan Alker has written about. The Biden Administration sent letters to states with approved work requirements that “preliminarily” disapproved the policy on the basis of the COVID-19 pandemic and uncertainty of its aftermath on health and […]
Medicaid Wars: Rescind and Withdraw (Episode II)
The Biden Administration has a long list of bad Medicaid policies to unwind. As chronicled in Episode I, the groundwork for the unwinding was laid in a Presidential Executive Order, “Strengthening Medicaid and the Affordable Care Act,” issued on January 28. Among other things, the E.O. directs the Secretary of HHS to review section 1115 demonstrations and […]
Trump’s Farewell Gift to Florida’s Medicaid Program
A few days before departing, former CMS Administrator and Trump appointee Seema Verma handed out ten-year Medicaid demonstration waiver extensions for political allies, with Texas and Florida,[1] approvals being granted late Friday, January 15th. The Friday before (Jan. 8th) CMS had approved the infamous and dangerous Tennessee waiver, which my colleagues explained beautifully here. Ten […]
Groups Call on HHS to Cut Red-Tape and Remove Barriers to Medicaid Coverage
A total of 116 organizations led by Georgetown University CCF and the Center on Budget and Policy Priorities sent a letter to the Acting Secretary of HHS urging immediate action to protect people who rely on Medicaid for their health insurance and who live in states with proposed or approved section 1115 work and community […]
Biden Administration Signs Health Care Executive Orders, Puts Welcome Mat Back Out
Today January 28th is Health Care theme day for the Biden Administration, which is in the midst of releasing a carefully orchestrated set of Executive Orders (EO) on a range of issues. Two Executive Orders were signed by the President today, the first to strengthen the Affordable Care Act and Medicaid, and the second to […]