Testing New Program Features through Section 1115 Waivers

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April 2019 | Waivers, Medicaid and the Affordable Care Act

Section 1115 waivers allow states to test approaches to coverage that are not allowed under traditional Medicaid. Under Section 1115 of the Social Security Act, the Secretary of the U.S. Department of Health and Human Services can waive almost any Medicaid state plan requirement under Section 1902 of the Act to the extent necessary to carry out a demonstration or experimental project furthering the goals of the program. States use these waivers for a wide variety of different purposes. This brief focuses on recently adopted state waiver programs that make changes to eligibility and enrollment policies, benefit design, and cost-sharing requirements for low-income adults who are not eligible for Medicaid on the basis of disability.

This issue brief summarizes the main design features of approved waivers, including populations covered, eligibility and enrollment, benefits, premiums and cost sharing, and the delivery system. State-specific waiver information, which is updated more frequently than this overview issue brief, is summarized at the individual links below.

Publication Type: Issue Briefs

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Tags: adults, Affordable Care Act, benefits, childless adults, copayments, cost sharing, eligibility, Medicaid expansion, new adult group, premium assistance, premiums, Section 1115 research and demonstration project waivers, waivers