According to the National Association of State Budget Officers, Medicaid now consumes 23.6 percent of state governments’ expenditures. Fortunately for state policymakers, there is now an option available to them to help create greater access to high-quality, more-affordable health care without increasing state budgets or the national debt: Section 1115 waivers.

Under Section 1115 of the Social Security Act, the secretary of Health and Human Services can approve experimental, pilot, or demonstration projects likely to assist in promoting the objectives of the Medicaid law. To get a Section 1115 waiver approved, a state must prove to the HHS secretary that its proposal meets the goals of the Medicaid program and federal budget requirements. Section 1115 waivers generally are approved for a five-year period and then must be renewed.