Concise Research Report: The Future of Medicaid: State Legislator Views on Policy Waivers
As the Medicaid program is defined increasingly at the state level, state legislators will have growing influence on the direction of a program that now covers 72.4 million low-income adults and children.1 While Medicaid’s federal-state partnership structure has long permitted states to adopt modifications to coverage design, the Trump administration has made it easier for states to receive Medicaid waivers,2 including fast-track approvals and longer demonstration approval periods. The combination of greater state flexibility and reductions in overall funding could produce substantial shifts in state Medicaid policy; the recent approval of Kentucky’s Section 1115 waiver, which included work eligibility requirements, may be a precursor to impending program changes rather than an outlier. Understanding state legislator views of the Medicaid program and proposed changes is therefore critical to addressing future policy directions.
Using the National Conference of...
KEY WORDSmedicaid health reform health insurance state health policy
We would like to thank David Asch, Janet Weiner, and Rebecka Rosenquist for their review of prior drafts, Kira Flemke for administrative and logistical contributions, and Christopher M. Aderman for graphics assistance.
This study was funded by the Leonard Davis Institute of Health Economics at the University of Pennsylvania.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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