Fact Sheet
April 2018

Restrictive Medicaid 1115 Waivers: Status in the States

An increasing number of states are making harmful changes to their Medicaid programs using “Section 1115 waivers.” Families USA is tracking state Medicaid waivers that restrict access to quality, affordable health care for low-income families and adults. This new grid offers an overview of the status of each state’s waiver proposal, the restrictive elements of the waiver proposal, and CMS’s decision on each element. 

Advocacy Guide
April 2018

Advocacy Timeline: Opposing Restrictive Medicaid Section 1115 Waivers

Since the Trump Administration took office, several states have asked the Centers for Medicare and Medicaid Services (CMS) for approval to waive Medicaid requirements or add new ones through requests known as Medicaid Section 1115 waivers. View our timeline below of the different stages that occur before these requests get to CMS.

March 30, 2018

Troubling Trends for Oral Health in Medicaid Waivers

Today, Medicaid faces unique threats, and these threats are happening largely below the radar screen. So far, we have succeeded in averting multiple attempts to erode Medicaid as we know it through federal legislation, but efforts to undermine coverage continue through legally questionable regulatory actions and destructive Medicaid waivers. These Medicaid waivers have the potential to have a profound impact on children, families, and their oral health coverage. 

Fact Sheet
March 2018

Work Requirements in Medicaid Waivers: These Aren’t About Work

CMS has approved work requirements (sometimes spun as “community engagement” requirements) in three states: Arkansas, Kentucky, and Indiana. Eight additional states have similar requests pending, and CMS appears likely to approve those requests, as well. Litigation challenging the authority of the executive branch to approve work requirements—rules that are contained nowhere in Medicaid law—have also begun.

View our 50-state map to see Medicaid waiver activity in the states.

Fact Sheet
March 2018

What CMS Did and Didn’t Approve in Arkansas’ Waiver—Both Tell Us A Lot

On March 5, 2018, CMS approved Arkansas’ request to add a work requirement to its Medicaid program.  Equally important, it did not approve the state’s request to roll back Medicaid eligibility to a partial Medicaid expansion. Both tell us a lot about what’s behind CMS’s approach to Medicaid waivers, and what states can expect to have, and not have, approved. View factsheet here.


December 5, 2017

Drug Testing in Medicaid Is Illegal and Hurts the People Who Need Help Most

Recently, the state of Wisconsin submitted an application to the federal government seeking Medicaid waiver authority to make drug testing a condition of eligibility for the state’s adult Medicaid program--BadgerCare. This request breaks dangerous new ground; drug testing has never been allowed as part of the application process in the Medicaid program. That’s because it is illegal, it will make it harder for everyone applying for Medicaid, and it will hurt rather than help those with substance use disorders.

September 15, 2016

CMS Rejects Ohio's Request for Harsh Policies in Its Medicaid Program

Erica Turret

Villers Fellow
Last week, CMS rejected Ohio’s request to make significant changes to its Medicaid program. 

With this decision, CMS is making it clear that policies that make it harder for the lowest-income people in the program to get health care are inconsistent with the goals of Medicaid. The decision also defined some boundaries regarding what is and is not appropriate for approval through the Medicaid waiver process.

September 8, 2016

Medicaid Expansion Improves People’s Financial Stability

Nygel Williams

Villers Fellow

Last month, Kentucky asked the federal government for approval to make significant and troubling changes to its highly successful Medicaid expansion program. To justify its request, the state asserted that these changes would help “break the cycle of poverty.” However, the results would likely be the opposite.

The fact is, by providing health insurance and helping people in the program avoid medical debt, Medicaid coverage can actually improve the financial health of its enrollees. Two recent reports, one in April and one in June, offer new evidence supporting that link.  

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