Seven states (Arizona, Arkansas, Iowa, Indiana, Pennsylvania, Michigan, and New Hampshire) have used Section 1115 research and demonstration waivers to extend coverage to adults that gained Medicaid coverage under the Affordable Care Act. Section 1115 waivers allow states to test innovations that are not otherwise permitted under the federal Medicaid statute.
This presentation describes findings from over 30 structured interviews with state Medicaid agency staff, representatives of health plans, and evaluators to look at the experience of four states — Arkansas, Indiana, Iowa, and Michigan in implementing new approaches to coverage. The project, conducted by the State Health Access and Data Center (SHADAC) at the University of Minnesota, under contract to MACPAC, focused on exchange plan premium assistance, enrollee contribution requirements, health savings accounts, healthy behavior incentives, and graduated copayments for non-emergency use of the emergency room.