Nearly 75 million U.S. residents have health insurance coverage through Medicaid. Benefits and program designs vary from state to state. One source of state-based variation is Section 1115 projects, which are defined as “experimental, pilot, or demonstration” programs that are “likely to assist in promoting the objectives” of the Medicaid statute. States seeking to implement experimental policies in their Medicaid programs must apply to the Centers for Medicare and Medicaid Services (CMS) for a Section 1115 waiver, which lifts certain federal regulations for 5 years. Thirty-seven states had active Section 1115 waivers as of October 31, 2018, and more than one third of Medicaid spending goes toward Section 1115 programming.
Law | Medical Jurisprudence
Kristen Underhill, Atheendar Venkataramani & Kevin G. Volpp,
Fulfilling States’ Duty to Evaluate Medicaid Waivers,
N. Engl. J. Med.
Available at: https://scholarship.law.columbia.edu/faculty_scholarship/3333