Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states considerable flexibility in how they operate their programs, beyond what is available under current law, and can have a significant impact on program financing. While there is great diversity in how states have used waivers over time, waivers generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS) (see Appendix A). As of September 2017, there are 33 states with 41 approved waivers and 18 states with 21 pending waivers (see Appendix B and C for detailed tables).2 3 This brief answers basic questions about Section 1115 waiver authority and discusses the current landscape of approved and pending demonstration waivers.
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