Medicaid Waivers

Most Americans assume that our health insurance safety net covers the poor, regardless of family status.  In reality, a majority of uninsured Americans are low-income, childless adults who are not eligible for public health insurance programs. Out of the approximately 47 million people who are currently uninsured in the United States, 34 percent or 16 million people, are low-income childless adults.

Since the mid-1990s, 26 states have implemented Medicaid Section 1115 family planning demonstration waivers to help low-income women avoid unintended pregnancy and improve child and maternal health outcomes. These waivers have saved states millions of dollars. The waiver programs, which require approval from the Centers for Medicare and Medicaid Services (CMS), provide access to family planning services for individuals not otherwise eligible for Medicaid or the State Children’s Health Insurance Program (SCHIP). This State Health Policy Briefing is the third is a NASHP series examining Medicaid family planning demonstration waivers. It explores some of the design choices states face when applying for and implementing a waiver – choices about whom the program should cover, how it should cover them, and how states can ensure that clients receive the services they need.