In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.
Work and Community Engagement Requirements in Medicaid: State Implementation Requirements and Considerations
Patricia Boozang, Allison Orris, Mindy Lipson, and Deborah Bachrach, Manatt Health
In January 2018, the Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter providing guidance to states as to the circumstances under which CMS would approve 1115 demonstration waivers making work/community engagement (CE) requirements a condition of Medicaid eligibility. Since then, CMS has approved state work/CE waivers in Arkansas, Indiana, Kentucky, and New Hampshire, and additional states have submitted or are poised to submit similar waivers. Manatt Health has produced a series of charts that outline the legal, policy, financial and operational tasks and issues that states will face in adding a work/CE condition to their Medicaid program.
If you are interested in only one of the charts, they are also available as individual resources:
State Health and Value Strategies also recently hosted a webinar, Explaining the Stewart v. Azar Decision and Implications for States, that provided an overview of the Stewart v. Azar decision and its potential implications for states with approved, pending or planned Medicaid waivers that include work/community engagement requirements.