Medicaid/SCHIP: Waivers - Kaiser Family Foundation

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Medicaid/SCHIP: Waivers

Vermont's Global Commitment Waiver: Implications for the Medicaid Program
This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program.

New Fact Sheet Summarizes Healthy Indiana Plan and Outlines Key Issues
This fact sheet provides an overview of Indiana's new Medicaid waiver program, the Healthy Indiana Plan, which is the first that allows a state to use Medicaid funds to provide a beenfit package modeled after a high-deductible plan and health savings acount to previously uninsured adults. The piece examines key components of the plan and identifies key issues to consider.

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Healthy Indiana Plan: Key Facts and Issues -- June 2008

This fact sheet provides an overview of Indiana's new Medicaid waiver program, the Healthy Indiana Plan, which is the first that allows a state to use Medicaid funds to provide a benefit package modeled after a high-deductible plan and health savings account to previously uninsured adults. This piece examines key components of the plan and identifies key issues to consider.

Choosing Premium Assistance: What Does State Experience Tell Us? -- June 2008

This brief examines six state premium assistance programs (in Florida, Idaho, Illinois, Oregon, Utah, and Virginia) that allow families to choose to receive a subsidy to apply to the purchase of private coverage rather than to receive direct Medicaid or SCHIP coverage.

Kaiser Fast Facts -- May 2008
“Kaiser Fast Facts” features “QuickTakes” and “Kaiser Slides” – two tools that provide direct access to facts, data and slides about the nation's health care system and programs, in an easy-to-use format. “QuickTakes” presents an inventory of facts-at-a-glance and "Kaiser Slides" allows Web visitors to freely view, download and print graphics and tables of health policy statistics and trends.

Medicaid's Role in Family Planning -- October 2007
The Alan Guttmacher Institute and the Kaiser Family Foundation have updated this issue brief to provide an overview and analysis of the important role that Medicaid plays in financing family planning services to low-income women across the nation.

Louisiana’s Proposed Section 1115 Medicaid Demonstration Project: Estimating the Numbers of Uninsured and Projected Medicaid Costs -- July 2007

This brief analyzes the composition and medical costs of the uninsured in Louisiana after Hurricane Katrina

Family Coverage Under SCHIP Waivers -- May 2007

This paper examines the 11 states that provide parental coverage through their SCHIP programs via a federal waiver.

West Virginia Medicaid State Plan Amendment: Key Program Changes and Questions -- July 2006

This fact sheet summarizes the key changes West Virginia has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005.

KYHealth Choices Medicaid Reform: Key Program Changes and Questions -- July 2006

This fact sheet summarizes the key changes Kentucky has approved for its Medicaid program as a result of the new options available through the Deficit Reduction Act of 2005.

The Vermont Choices for Care Long-Term Care Plan: Key Program Changes and Questions -- July 2006

This fact sheet summarizes Vermont’s Section 1115 waiver to make fundamental changes to its Medicaid program that provides long-term services and supports to eligible, low-income state residents.

New Developments in Medicaid Coverage: Who Bears Financial Risk and Responsibility? -- June 2006

This brief examines how some new state initiatives change financial risk and responsibility for states, the federal government, beneficiaries and providers.

This fact sheet provides an overview of Indiana's new Medicaid waiver program, the Healthy Indiana Plan, which is the first that allows a state to use Medicaid funds to provide a benefit package modeled after a high-deductible plan and health savings account to previously uninsured adults. This piece examines key components of the plan and identifies key issues to consider.

This brief examines six state premium assistance programs (in Florida, Idaho, Illinois, Oregon, Utah, and Virginia) that allow families to choose to receive a subsidy to apply to the purchase of private coverage rather than to receive direct Medicaid or SCHIP coverage.

“Kaiser Fast Facts” features “QuickTakes” and “Kaiser Slides” – two tools that provide direct access to facts, data and slides about the nation's health care system and programs, in an easy-to-use format. “QuickTakes” presents an inventory of facts-at-a-glance and "Kaiser Slides" allows Web visitors to freely view, download and print graphics and tables of health policy statistics and trends.

The Alan Guttmacher Institute and the Kaiser Family Foundation have updated this issue brief to provide an overview and analysis of the important role that Medicaid plays in financing family planning services to low-income women across the nation.

This brief analyzes the composition and medical costs of the uninsured in Louisiana after Hurricane Katrina

This paper examines the 11 states that provide parental coverage through their SCHIP programs via a federal waiver.

This fact sheet summarizes the key changes West Virginia has approved for its Medicaid program as a result of the new flexibility available through the Deficit Reduction Act of 2005.

This fact sheet summarizes the key changes Kentucky has approved for its Medicaid program as a result of the new options available through the Deficit Reduction Act of 2005.

This fact sheet summarizes Vermont’s Section 1115 waiver to make fundamental changes to its Medicaid program that provides long-term services and supports to eligible, low-income state residents.

This brief examines how some new state initiatives change financial risk and responsibility for states, the federal government, beneficiaries and providers.

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Medicaid/SCHIP: Waivers

Medicaid and the State Children’s Health Insurance Program (SCHIP) are jointly funded by the federal government and states. States administer their Medicaid and SCHIP programs subject to requirements and options established by federal law. Nationwide, about two thirds of all Medicaid spending is at state option.

Waivers allow states to use federal Medicaid or SCHIP dollars in ways that do not conform to existing federal standards and options. The broadest source of federal waiver authority is section 1115 of the Social Security Act, which allows the Secretary of the U.S. Department of Health and Human Services (HHS) to approve research and demonstration projects that "further the objectives" of the program. Under Section 1115 waivers, states can make broad changes in their Medicaid programs, such as changes in eligibility, benefits, or cost sharing for a group of people that otherwise would not be allowed under federal law. Medicaid section 1115 waivers are not new, but recently HHS has been promoting them through two waiver initiatives--the Health Insurance Flexibility and Accountability (HIFA) initiative and the Pharmacy Plus initiative. HIFA provides states increased flexibility in financing their waivers, including allowing states to reduce coverage for people already eligible for Medicaid to offset the cost of expansions to new groups of people. Under Pharmacy Plus waivers, states can use federal matching funds for the cost of operating prescription drug-only programs for seniors who would not otherwise be eligible for Medicaid. States, generally, must accept a global cap on total federal Medicaid funding as part of the Pharmacy Plus waiver.

Additionally, states can use 1915(c) waivers to provide home and community-based services to individuals who are at risk of institutionalization in a hospital, nursing home, or Intermediate Care Facility for Individuals with Mental Retardation (ICF/MR). Under these waivers, states can provide services not otherwise covered by Medicaid; target specific geographic areas, populations, or conditions; and cap enrollment.