Medicaid Waiver Priorities Under the Trump and Biden-Harris Administrations

Section 1115 Medicaid demonstration waivers allow states to trial new Medicaid approaches, with each US administration having differing priorities. US administrations also have some control over how waivers get approved. The Trump administration’s policy on Section 1115 waivers pushed for work requirements and other eligibility restrictions. In contrast, the Biden-Harris administration has urged states to propose waivers that broaden coverage, reduce health disparities, and advance whole-person care.