Advocacy Resources around Medicaid Waivers

Dear Partners,

To date 30 states and the District of Columbia have closed the coverage gap. Most of the remaining states have yet to do so because of political barriers. For these states, a Medicaid waiver that allows flexibility around covering newly eligible adults may be the only feasible path to expansion. Advocates can shape these waivers to ensure consumer interests are represented and to minimize any barriers to coverage or care.

We wanted to share a few resources to support advocates in shaping waivers:

  • A policy paper that summarizes the evidence we have of how beneficiaries and state budgets are impacted by common Medicaid waiver provisions. This policy paper is also summarized in a one-page version and
  • A case study that showcases the strategies that advocates in Pennsylvania used throughout their Medicaid expansion waiver negotiation process to challenge anti-consumer elements and ultimately protect consumers.

Additionally, below are some resources to help advocates promote consumer-friendly policies for the designation and enrollment of individuals deemed “medically frail” into appropriate health plans. In states where the adult benefit package differs from traditional Medicaid coverage, or in states that have adopted Marketplace premium assistance, medically frail individuals will have a wider choice of benefit packages.

  • An issue brief developed by The National Council for Behavioral Health and Community Catalyst about medically frail policy and best practices;
  • An advocacy tool to help advocates improve medically frail policies in states that currently have them; and
  • An advocacy tool for advocates in states considering a Medicaid waiver that would necessitate developing medically frail policies.

If you have any questions or want to talk more about these resources, contact Amber Ma at ama@communitycatalyst.org.

Thank you for your continued advocacy,

Community Catalyst Close the Gap Team

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