Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State

This page tracks approved and pending Section 1115 Medicaid demonstration waivers, which offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute. Key themes in current approved and pending waivers include targeted eligibility expansions, benefit expansions (particularly in the area of behavioral health, such as coverage of services provided in IMDs), and provisions related to social determinants of health. States may obtain “comprehensive” Section 1115 waivers that make broad changes in Medicaid eligibility, benefits, provider payments, and other rules across their programs; other waivers may be more narrow and address specific populations or benefits.

Section 1115 waivers generally reflect priorities identified by the states and the federal Centers for Medicare and Medicaid Services (CMS), as well as changing priorities from one presidential administration to another. In particular:

• Beginning in the 1990s, there was an increase in waiver activity, and waivers became broader in scope. Under different administrations in the past, waivers have been used to expand coverage, modify delivery systems, and restructure financing and other program elements.
• The Trump Administration’s Section 1115 waiver policy emphasized work requirements and other eligibility restrictions, payment for institutional behavioral health services, and capped financing.
• The Biden administration withdrew waiver approvals with work requirements, phased out approval of premium requirements, and has instead encouraged states to propose waivers that expand coverage and reduce health disparities. Specifically, key waiver themes under the Biden administration have included approvals related to addressing health-related social need (HRSN), pre-release coverage, and multi-year continuous eligibility for children. See the “Key Themes Maps” tab for current maps of states with approvals in these areas.

This page tracks approved and pending Section 1115 waiver provisions (including expansions and restrictions) related to eligibility, benefits, and social determinants of health and other delivery system reforms, once such waivers are posted to the State Waivers List on Medicaid.gov. This information is contained in the following tables:

Detailed Topic Tables

• Waivers with Eligibility Changes
• Waivers with Benefit Changes
• Waivers with SDOH & Other DSR Changes

Aggregate State Tables

• All Approved Waivers by Topic
• All Pending Waivers by Topic

For more information on inclusion criteria and on each provision, as well as a list of acronyms, see the Definitions tab.