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.
The Tennessee Waiver: Block Grant, Aggregate Cap, or Windfall?
In their wondrous 1957 interpretation of a Gershwin classic, Ella Fitzgerald and Louis Armstrong sing, “You like potato and I like potahto/You like tomato and I like tomahto.” Their back-and-forth has echoes in the current debate over what to call the TennCare III demonstration, approved on January 8 by the former CMS Administrator, Seema Verma. […]
Trump Administration Tries Its Best to Knock Legs Out from Under Medicaid on the Way Out the Door
So far 2021 has been a really wild and difficult ride for me and millions of others in the U.S. with COVID-19 ravaging the nation, an armed insurrection here in DC, and an ongoing economic crisis leaving so many families in need. My mind has been struggling to absorb all that is happening so quickly. […]
Limited Postpartum Medicaid Coverage Extensions are a Missed Opportunity
States are continuing to push for extending Medicaid coverage for postpartum women beyond the current federal cutoff of 60 days after the end of their pregnancy. Just in the last month, three more states submitted waiver applications to CMS: Indiana, Georgia, and Texas. Before the end of the year, we submitted comments on Indiana’s limited […]
What Can We Expect from Biden Administration on Work Reporting Requirement Waivers?
As I was waiting to watch Vice President-elect Kamala Harris start her speech on Saturday night, I tweeted the following: Goodbye and good riddance to Medicaid work requirement waivers. — Joan Alker (@JoanAlker1) November 8, 2020 It proved to be a popular sentiment – at least on my twitter feed. As we have blogged about […]
Georgia’s Medicaid Waiver is Fiscally Foolish and Anti-Family
On October 15th, the Centers for Medicare and Medicaid Services Administrator Seema Verma traveled to Atlanta to announce the approval of Georgia’s “Pathways to Coverage” Section 1115 Medicaid demonstration. The approval is the latest in CMS Administrator Verma’s ideological crusade to “reframe” Medicaid and promote her signature initiative — work requirements. The creation of a […]
More Evidence Medicaid Work Requirements Don’t Actually Work
A new study from Ben Sommers and other researchers at Harvard University finds that Medicaid work requirements fail to promote employment but do result in more people losing their health coverage and may promote other negative health outcomes. The study, published in Health Affairs, found that negative economic consequences ensued as well – with medical […]