Medicaid Waiver Would Free Up $2.7 Billion for Improvements

Today, Governor Rauner joined agency directors, local officials and stakeholders today to announce Illinois has officially submitted the 1115 Medicaid waiver proposal to the federal government. The waiver will allow Illinois to use innovative health strategies for better coordination and integrated care, and will address behavioral health and substance abuse treatment for some of the state’s most vulnerable residents. The changes the Administration is seeking will allow the State to intervene earlier and increase access to services, leading to more stability and a more productive life.

The waiver was developed from the collaboration between 12 state agencies and the Governor’s Office, as well as community partners and stakeholders. The state sought input from more than 2,000 stakeholders and incorporated feedback from roughly 200 written responses. The State also held public hearings to gather further input from stakeholders. The State hopes to work with the federal Centers for Medicare and Medicaid Services (CMS) to finalize the waiver as soon as possible.

Illinois made the request to use $2.7 billion in federal Medicaid funds that would not otherwise be offered. The money will be invested in early interventions and infrastructure over the next five years to improve the quality of care delivered while avoiding more costly admissions and treatment.

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. The purpose of these demonstrations, which give states additional flexibility to design and improve their programs, is to demonstrate and evaluate policy approaches such as:

  • Expanding eligibility to individuals who are not otherwise Medicaid or CHIP eligible;
  • Providing services not typically covered by Medicaid; or
  • Using innovative service delivery systems that improve care, increase efficiency, and reduce costs.

Demonstrations must also be “budget neutral” to the Federal government, which means that during the course of the project Federal Medicaid expenditures will not be more than Federal spending without the waiver.