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Issue Brief
June 2012

State Plan Amendments and Waivers: How States Can Change Their Medicaid Programs

States have the flexibility to change their Medicaid programs at any time. To do so, they must submit either a state plan amendment or a waiver. Each option has different requirements and processes, and they each allow states to change their Medicaid programs in different ways.

Advocates can use this issue brief to learn about the critical differences between state plan amendments and waivers. And advocates can consult the at-a-glance chart to see how the two options compare. Because advocacy strategies will differ depending on which option a state pursues, a grasp of the differences between each option is important, as this brief shows.