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Overview and update of California's Initiative on Section 1115: Waiver Coverage Expansions

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Publication Date: November 2007

Publisher(s): Insure the Uninsured Project

Author(s): Jay Espejo

Funder(s): California Endowment; Blue Shield of California Foundation; California Wellness Foundation

Funder(s): California Endowment; Blue Shield of California Foundation; California Wellness Foundation

Topic: Health (Health services for the uninsured)

Keywords: healthcare for uninsured; universal healthcare; healthcare reform

Type: Report

Coverage: California

Abstract:

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services the authority to grant states the ability to "experiment, pilot or demonstrate projects which are likely to assist in promoting the objectives" of Medicaid. To carry out such projects, states are allowed to alter Medicaid eligibility requirements, benefit criteria, payment provisions, and other such rules. Under this statute, California was granted $180 million annually in federal matching funds for years three through five of a five year demonstration for health coverage expansion.

The state decided on pilot initiatives to be developed at the county level. Counties throughout the state submitted proposals for a share of this allocation to help fund their projects. Ten counties were approved for funding. While no state contract has been finalized, highlights of some of the counties' proposed coverage initiatives and updates on the progress of these programs are covered.