Medicaid/SCHIP: Waivers - Kaiser Family Foundation

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Medicaid/SCHIP: Waivers

Vermont Increases Access and Expands Eligibility to Home and Community-based Services in Medicaid Long-term Care Experiment
This report examines the experience of Vermont’s Choices for Care experiment in delivering long-term services, created through a five-year Medicaid waiver in 2005. The state has seen a shift of people and money toward community settings, but also the return of waiting lists for some populations.

Florida's Medicaid Reform: Article and Policy Brief
Based on the Kaiser's 2006-2007 Survey of Florida Medicaid Beneficiaries, this Health Affairs article finds that many enrollees in the state's reform program lacked key information about their Medicaid changes, leading to reporting difficulties choosing a health plan.

Recent Documents: (57 results)

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Medicaid: A Primer 2008 -- December 2008
The primer provides an overview of the basic components of Medicaid, the nation's largest health coverage program, which covers 59 million low-income individuals, including children and families, people with disabilities and the elderly who are also covered by Medicare.

The Medicaid Program at a Glance - UPDATE -- November 2008

This fact sheet provides an overview of the Medicaid program, the populations that it serves and the services that it covers.

Vermont's Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year -- November 2008

This case study report examines the experience of Vermont's Choices for Care experiment in delivering long-term services, created through a five-year Medicaid waiver in 2005. The state has seen a shift of people and money toward community settings, but also the return of waiting lists for some populations.

Health Affairs Article: Florida's Medicaid Reform: Informed Consumer Choice? -- October 2008

Based on the Kaiser Family Foundation's 2006-2007 Survey of Florida Medicaid Beneficiaries, this Health Affairs article finds that many enrollees in the state's reform program lacked key information about their Medicaid changes, leading to reporting difficulties choosing a health plan.

Florida Medicaid Reform Waiver: Early Findings and Current Status -- October 2008

Florida Medicaid Reform Waiver: Early Findings and Current Status

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

The primer provides an overview of the basic components of Medicaid, the nation's largest health coverage program, which covers 59 million low-income individuals, including children and families, people with disabilities and the elderly who are also covered by Medicare.

This fact sheet provides an overview of the Medicaid program, the populations that it serves and the services that it covers.

Florida Medicaid Reform Waiver: Early Findings and Current Status

“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

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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.