Mississippi has received the first-ever 10-year extension of a Medicaid Section 1115 demonstration waiver, allowing the state to continue providing family planning services for people with income of up to 194% of the federal poverty level.
The CMS said the 10-year extension is part of the agency's effort to give states greater flexibility in running their Medicaid programs, without having to ask the government for frequent approvals. Up to now, the agency typically granted Section 1115 waivers, which are supposed to be budget-neutral for the federal government, for five-year periods.
The CMS noted that it will use a new streamlined template for annual monitoring and reporting of the state's performance on the demonstration waiver program.
"This is the first 10-year demonstration extension in the history of CMS, and allows Mississippi to administer its Medicaid program without the inconvenience of obtaining routine approvals from CMS," Administrator Seema Verma said. "This action shows our continuing commitment to giving states the flexibility they deserve to meet the unique needs of their people."
The CMS approval letter dated Thursday did not indicate the total cost of the Mississippi waiver program or how many state residents would benefit from it. The per-person per-month spending cap is $67 for 2018, rising to nearly $96 in 2027, the final year.
The waiver program offers benefits for family planning and related services for low-income women and men ages 13 through 44 who are not enrolled in Medicaid, Medicare, the Children's Health Insurance Program, or other qualifying health plans that include family planning services.
Mississippi has not expanded Medicaid to people with incomes up to 138% of poverty. If it did, many of the waiver beneficiaries would be able to receive family planning along with comprehensive health benefits through the regular Medicaid program.
Mississippi's Republican elected officials have tried to limit the ability of Planned Parenthood to deliver family planning and other women's health services by passing a law barring that organization from receiving Medicaid funds. That law was blocked by the courts.
In the coming months, Verma and the CMS are expected to grant controversial Medicaid waivers to a number of Republican-led states allowing them to set cost-sharing, work and other requirements on low-income people as a condition for receiving health benefits.
That's part of the Trump administration's commitment to give states greater leeway in how they run their Medicaid programs. The states project that these moves will reduce the number of people enrolled in Medicaid.
An edited version of this story can also be found in Modern Healthcare's Jan. 1 print edition.
