SCI 3.06 Issue Brief.qxd

Under section 1115 of the Social Security Act, the Secretary of Health and Human Services has the authority to waive many provisions in the Medicaid and State Children’s Health Insurance Program (SCHIP) statutes. Section 1115 demonstrations have long been an important vehicle for states to not only expand health insurance coverage, but also provide a launching pad for changes to their underlying programs. In the early days of Medicaid managed care, section 1115 was a useful vehicle for implementing mandatory managed care enrollment for large segments of state’s eligible populations. States would then use section 1115 authority to redirect the ensuing savings into coverage expansions.