Tag Archives: Katherine Wentworth

Section 1115 waivers provide emergency support options

The coronavirus has forced states to build emergency action plans for their Medicaid programs at lightning speed. Nearly all have begun with the Section 1135 “blanket waivers” issued by the Centers for Medicare and Medicaid Services (CMS), but as the pandemic continues, many are seeking additional options.

A variety of broader policy and expenditure options are available under emergency 1115 waivers and other federal authorities to support states with accelerated access to emergency assistance for Medicaid recipients and healthcare providers. In this paper, Milliman consultants discuss options for states to consider as they build their emergency response.

Health Adult Opportunity 1115 waiver option considerations

On January 30, the Centers for Medicare and Medicaid Services (CMS) introduced guidance describing the new Healthy Adult Opportunity (HAO) 1115 waiver option. This option outlines conditions under which a state might convert open-ended matching funding for expansion adults into a block grant or per capita program.

The HAO offers states new flexibilities for their Medicaid programs in return for assuming the financial risk of block grants. State program directors face many complex considerations as they evaluate these options. While the HAO will clearly appeal to states that have previously considered requesting a block grant, the range of policy options made available under this initiative may bear considerations for states across the country.

In this paper, Milliman’s consultants discuss 10 key considerations for states evaluating the HAO.