Under the Affordable Care Act (ACA), 41 states (including the District of Columbia) have taken advantage of federal subsidies and opted to expand Medicaid eligibility leading to a dramatic increase in Medicaid enrollment.
Many states have taken advantage of 1115 demonstration waivers through CMS. Through these waivers, the Secretary of the Department of Health and Human Services may waive certain provisions of the Medicaid law to give states additional flexibility to design and improve their programs.
The Medicaid and CHIP Payment and Access Commission (MACPAC) is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP). The MACPAC releases its Reports to Congress twice annually, by March 15 and June 15 respectively.