This Note explores recent state efforts to reshape their respective Medicaid programs through Section 1115 waivers. Specifically, this Note looks at states that wish to convert their Medicaid program to a block grant through Section 1115 waivers. Examining the lawfulness of these waivers requires analyzing the language and application of both the Medicaid Act and the Administrative Procedure Act. This Note argues that any use of Section 1115 waivers to implement a block grant program would be a violation of the Medicaid Act and thus unlawful. Further, federal approval of such programs would be deemed arbitrary and capricious. To justify this conclusion, this Note considers three recent federal court decisions striking down states’ use of Section 1115 waivers to enforce Medicaid work requirements. This Note determines that any use of Section 1115 waivers to create a block grant program would face similar legal challenges as the work requirements cases.
“Waiving” Goodbye to Medicaid as We Know It: Modern State Attempts to Transform Medicaid Programs Through Section 1115 Waivers
November 9, 2020