Medicaid: the Flexible State-Federal Program

Medicaid: the Flexible State-Federal Program

How Medicaid provides flexibility to the states

Congressional proposals have argued that states deserve more flexibility in their Medicaid programs. But states already have great flexibility in their Medicaid programs. Every state has a its own Medicaid plan. States can permanently alter the payments rates, services covered, benefit and benefit limits, and their cost-sharing in partnership with the federal government. They can also try out changes in services, payment models, and eligibility via five-year demonstration projects. Citizens can play an important role in shaping how their state’s program works.

States can alter their Medicaid programs
Each state has the flexibility to change the services covered, provider payment rates, benefit limits, and other features of its own Medicaid state plan. An overview of the mechanisms and how you can help shape your state’s program.
View/download one-pager

Plan Amendments allow program-wide changes
By amending its State Plan, the state can change provider payment rates, add or cut optional services, implement managed care, or change benefit regulations.
View/download one-pager

1115 waivers help states innovate
States can come up with new ideas: expand eligibility, provide new services, or transform the way they coordinate services.
View/download one-pager

States can tame costs with managed care
By limiting how much can be spent each month per person enrolled, states can work to maximize Medicaid’s cost-effectiveness.
View/download one-pager

People with disabilities can stay in their homes
The single most widely used type of waiver lets states provide home and community-based services, keeping people with disabilities from being institutionalized.
View/download one-pager

Citizens can play a vital role
You can help shape these programs, both by offering input on proposed changes during public comment periods and by becoming informed Medicaid advocates.
View/download one-pager

 
To get the one-pagers as they come out sign up for our alerts.