What is a 1115 waiver?
An 1115 waiver, also called an 1115 demonstration, is used by a state that wants to make experimental or pilot demonstration changes to its Medicaid program.
1115 waivers have been used for decades, for a wide range of innovative changes to states' Medicaid programs.1
CMS has a webpage that shows a state-by-state list of approved, pending, and terminated 1115 waivers. In most cases, 1115 waiver approval is granted in five-year increments, so states need to periodically obtain new federal approval to keep an 1115 demonstration project in effect long-term.
Section 1115 of the Social Security Act gives the Secretary of HHS the authority to approve a state's 1115 waiver/demonstration proposal as long as it's determined that the state's proposal will "assist in promoting the objectives" of the Medicaid program.2
Medicaid work requirements are an example of 1115 waiver proposals that have gained significant media attention in recent years, but 1115 waivers can be used for a wide range of purposes.
Footnotes
- "The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election" KFF.org. Oct. 30, 2020 ⤶
- "Compilation of the Social Security Laws, Demonstration Projects" SSA.gov. Accessed Jan. 30, 2024 ⤶
