A number of states have sought Section 1115 research and demonstration waiver authority to implement changes to eligibility and enrollment policies, benefit design, and cost-sharing requirements for low-income adults who are not eligible for Medicaid on the basis of disability.
This fact sheet summarizes the main design features of the Wisconsin waiver, including eligibility and enrollment policies, covered benefits, required premiums and cost sharing, and how services are delivered (i.e. by fee for service or managed care).
The information in this fact sheet is current as of March 2020. The Biden Administration has since withdrawn Wisconsin’s authority to implement work and community engagement requirements, and notified the state that other elements of the demonstration are under review (CMS 2021).