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.


Expert Perspectives

October 11, 2024

CMS Offers New Details on Account Transfer 2.0

The Center for Medicaid and CHIP Services (CMCS) explained the transition to “Account Transfer 2.0” (AT 2.0) in a CMCS Informational Bulletin (CIB) released on October 10, 2024. The CIB indicates significant federal investment in improving the process of transferring consumer application information between state Medicaid and CHIP agencies and the Marketplace in the states using the federal platform. This expert perspective reviews the CIB and highlights opportunities for states to improve account transfer data under the CIB.

CMS Solicits Comments on Medicaid/CHIP Reporting Templates for Mental Health and Substance Use Disorder Parity

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.

September 27, 2024

States Have New Flexibility to Add Adult Dental Care to Essential Health Benefits

On April 2, 2024, the Centers for Medicare & Medicaid Services offered a new option for states to update their essential health benefits (EHB) benchmark plan to require coverage of routine adult dental benefits. While there are multiple drivers of inequities in oral health, a primary barrier to accessing dental services is the cost of care, a barrier that can be reduced with dental insurance. This expert perspective provides an overview of the newly available flexibility and discusses considerations for states weighing whether to add a requirement that plans subject to EHB cover routine adult dental care.