section 1115

During the Friday September 25, 2020 MACPAC meeting, MACPAC presented on the Management of HCBS Waiver Waiting Lists. The talk included background information on Medicaid and HCBS Waivers, data on HCBS Waiver waiting lists, and strategies for reducing or eliminating waiting lists. The slides from this presentation are included here.

This compendium includes select information on waiver capacity and waiting list management. The compendium highlights over 200 approved Section 1915(c) and Section 1115 waivers across all 50 states and DC. As an accompaniment to this compendium, MACPAC has also released an issue brief. This issue brief includes a description of the waiver analysis conducted in the compendium. It also features information from stakeholder interviews.

The Centers for Medicaid & Medicare Services released a report that profiled the 10 states with the greatest change in Long-Term Services and Support (LTSS) system balancing. The report highlights characteristics of the 10 states and compares their change in LTSS system balancing with other states and provides a national overview on LTSS system balancing. State profiles consist of characteristics and strategies states utilized in their progress towards rebalancing their LTSS systems.

This report highlights Medicaid waiver policies that could result in many people losing coverage, even as states incur greater costs. This report offers a detailed assessment of emerging waiver trends, providing insights into its critical implications. The report also describes how examining the research literature and evaluations of programs that impose similar policies can provide guidance on predicting the coverage and cost impacts of emerging waivers on Medicaid beneficiaries and states.

This issue brief highlights Medicaid HCBS enrollment and spending data from the Kaiser Family Foundation's 17th annual state survey. The report found that nearly all Medicaid HCBS enrollment (86%) and spending (93%) went to services provided at state option. This optional nature of most HCBS covered populations and services puts individuals at risk of losing services if the current structure of Medicaid financing were to change.