Examining the Effects of Medicaid Section 1115 Demonstration Waivers of Retroactive Eligibility

The goal of the project is to understand: 1) variations in Medicaid eligibility waiver design and demonstration implementation approaches among states with approved or pending retroactive eligibility waivers; 2) the extent to which presumptive eligibility and related Medicaid policies offset the effects of ending retroactive eligibility for certain providers and individuals; and 3) whether and how the waivers have affected individuals’ and families’ access to care, quality of care, and medical debt, providers’ uncompensated care costs, and Medicaid program costs and enrollment. The team will use a mixed-methods approach to the research. The qualitative component of the work will include an environmental scan, six case studies, and interviews. The quantitative component will use Medicaid and hospital data to model estimated changes in outcomes associated with retroactive eligibility waivers and compare Medicaid expansion states with and without such waivers.