Section 1115 waivers allow states to test innovations that are not permitted under traditional Medicaid. The Secretary of the U.S. Department of Health and Human Services has broad waiver authority under Section 1115 waivers; the use and scope of these waivers has expanded over time.
This presentation offers an overview of Section 1115 waiver requests of seven states—Arizona, Arkansas, Indiana, Kentucky, Maine, Utah, and Wisconsin—to implement work requirements as a condition of eligibility, place time limits on eligibility, or require drug testing on application. In addition to a review of the key features of each of these proposals, the presentation also discusses potential issues in their implementation and compares work requirements proposed for Medicaid with previous experience under the Temporary Assistance for Needy Families program.