Federal Flexibility Under Section 1115 Medicaid Demonstrations

Many states have been forcefully arguing for the Department of Health and Human Services (HHS) to grant extensive flexibility in the state administration of the Medicaid program. While some waivers have been authorized, many other waiver requests have not been granted. Federal controls are not a new concern for states, but the level of interest has reached a new intensity since more states have debated utilizing 1115 Demonstrations to implement Medicaid expansions under the Affordable Care Act (ACA).