Support for this issue brief was provided by the State Health and Value Strategies program, a grantee of the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

Section 1115 demonstration authority is one of the most powerful vehicles available to states to test innovation in their Medicaid programs. Under section 1115 authority, states can waive provisions of Medicaid law and obtain federal approval to fund initiatives not otherwise coverable by Medicaid, provided that proposals are budget neutral to the federal government and further the goals of the Medicaid program.

The federal government and states have used the flexibility available under section 1115 authority to advance shared priorities. In the past six months, the Centers for Medicare & Medicaid Services (CMS) has approved renewals of and/or amendments to several long-standing section 1115 demonstrations, showcasing the Biden administration's priorities for use of 1115 authority.

In an issue brief prepared for the Robert Wood Johnson Foundation's State Health and Value Strategies program, Manatt Health describes how recent approvals in Arizona, Arkansas, Massachusetts, Oregon and Vermont highlight that states and CMS are leveraging 1115 demonstrations to implement new coverage strategies, address social drivers of health, strengthen the primary care and behavioral health delivery systems, institute value-based payment initiatives, and advance health equity.

To read the full issue brief, click here.

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