States can use the Medicaid waiver process to greatly alter their programs in both positive and negative ways. Waivers allow states to use Medicaid dollars in ways that go beyond the scope of federal law. Many states have used waivers to make gains in covering more uninsured individuals, most notably non-disabled childless adults, or to help elderly and disabled adults move from institutions to receiving care in the community. Unfortunately, many states have also used waivers to take away benefits and to limit coverage. For more information on waivers, see our Waiver Toolbox.
On April 27, 2012, CMS regulations on Medicaid Section 1115 demonstration waiver transparency became effective. These new regulations make the comment process much more open and give the public an opportunity to comment on waivers both before and after states submit them to CMS. Just before the new regulations came into effect, several states submitted 1115 waivers to CMS (Florida, Kansas, Nevada, New Mexico, and Ohio). Even though the new rules do not apply to these waivers, there will still be an opportunity to submit comments on these waivers to CMS. To see these waivers (as well as all other pending waivers) and submit comments, go to www.medicaid.gov, and click on "pending waivers" in the "Waiver" box at the bottom of the home page. If the waiver you are looking for is not yet posted, keep checking back.