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Capitol Correspondence - 12.19.23

CMS Equity Brief Reveals Demographics and Trends in Section 1915(c) Waiver Programs

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The Centers for Medicare & Medicaid Services (CMS) has released a new equity brief shedding light on the Section 1915(c) Waiver Program, uncovering key findings about its participants and their demographics. The data, compiled from 2020, highlights that nearly all states, along with the District of Columbia, operated at least one Section 1915(c) waiver program, extending long-term Home and Community Based Services (HCBS) to approximately 1.7 million Medicaid enrollees.

The study reveals notable disparities among participants in these waiver programs compared to non-participants. Specifically, a higher proportion of Section 1915(c) waiver program enrollees are older (65+), dually eligible for Medicare, and non-Hispanic White. The findings provide valuable insights into the demographics of those accessing HCBS through these waivers.

A significant revelation from the equity brief is that over 40%of enrollees eligible for Medicaid based on disability received services for a behavioral health condition. This proportion is nearly double that of other adult eligibility categories, indicating a distinctive focus on addressing behavioral health needs within this population.

CMS emphasizes that this equity brief is part of ongoing efforts to measure disparities in access to care and make evidence-based investments to improve health equity for the Medicaid and CHIP population. The information presented in the brief, along with updated counts reflecting data from subsequent years, will be available for download at data.medicaid.gov.

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