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. The information in this issue brief is current as of June 2020. The Biden Administration has since withdrawn authority for work and community engagement requirements in many states. The Biden Administration also notified these states that other elements of their demonstrations are under review. State-specific waiver information is summarized at the individual links below.
Fact Sheets
- Arizona Waiver: Arizona Health Care Cost Containment System
- Arkansas Waiver: Arkansas Works
- Indiana Waiver: Healthy Indiana Plan 2.0
- Iowa Waiver: Iowa Wellness Plan
- Kentucky Waiver: Kentucky Helping to Engage and Achieve Long-Term Health
- Michigan Waiver: Healthy Michigan Plan
- Montana Waiver: Montana Health and Economic Livelihood Partnership
- New Hampshire Waiver: Granite Advantage Health Care Program
- New Mexico Waiver: Centennial Care 2.0
- Ohio Waiver: Ohio Group VIII Work Requirement and Community Engagement Section 1115 Demonstration
- Pennsylvania Medicaid Expansion Waiver
- South Carolina Waivers: Palmetto Pathways to Independence and Healthy Connections Works Demonstrations
- Wisconsin Waiver: BadgerCare Reform
- Utah Waiver: Section 1115 Primary Care Network Demonstration
