Issue Briefs | Jan 13, 2017

Overview of Alternative Medicaid Expansion Waivers

Patricia Boozang, Deborah Bachrach, and Mindy Lipson, Manatt Health

Section 1115 waivers allow states to waive certain Medicaid statutory requirements in order to advance state policy priorities and test innovations in their Medicaid programs, provided that they are budget neutral and “further the goals of the Medicaid program.”  Since 2014, seven states have used 1115 waivers to implement alternative Medicaid expansions, and these waivers are likely to be leveraged by states in the next four years to advance changes to Medicaid.  This issue brief, developed by Manatt Health, provides an overview of the features of these alternative Medicaid expansion waivers.  The document describes how approved waivers have approached aspects including premiums, cost-sharing, Health Savings-like Accounts, healthy behavior incentives, and several others, and can provide insight into state policy priorities and suggest areas where states may seek future waivers.