KFF August 25, 2025
Section 1115 Waiver Watch
On July 11, the Centers for Medicare and Medicaid Services (CMS) released a letter to states notifying them that going forward CMS does not anticipate approving new 1115 demonstration workforce initiatives or extending existing waivers. This is the latest action by the second Trump administration reversing major Biden administration waiver priorities. 1115 waivers generally reflect priorities identified by states as well as changing priorities from one presidential administration to another.
Gaps in access to certain providers (e.g., psychiatrists, primary care providers, dentists, and long-term care providers) have been ongoing challenges in Medicaid. Access gaps may reflect system-wide problems, but may be exacerbated by provider shortages in low-income communities, Medicaid’s lower physician payment rates, and lower Medicaid...
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