Medicaid Waivers


17 million people who gained coverage through Medicaid expansion could lose coverage and access to vital services.
On January 30, 2020, CMS Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS) announced a plan that would allow states to use the Medicaid waiver process to fundamentally alter Medicaid as we know it. The CMS proposal would make sweeping, detrimental changes in eligibility, health benefits, drug coverage, and premium costs for people who now receive Medicaid healthcare coverage as part of the program’s expansion which occurred under the Affordable Care Act.

CMS should NOT use the waiver process to remove coverage for so many vulnerable people in America who now are covered. Doing so directly threatens access to vital services – including treatment for behavioral health issues and substance abuse – for millions of people in our nation.

Under the CMS proposal, states would be able to use the waiver process to make dramatic changes to their Medicaid programs which have the frightening potential to strip coverage from the many millions of people who currently have it. Specifically, proposed changes would jeopardize the health and health coverage of the over 17 million people under age 65 in 37 states who currently are covered under Medicaid expansion.

Additionally, given Administrator Verma’s expressed interest in continuing to expand the use of the waiver process to make dramatic changes to Medicaid, her January 30th announcement may well be just a first step toward broader changes affecting all of Medicaid as the Administration tests how it can reshape the Medicaid program and its financing.

We must collectively work to ensure that Medicaid remains a guaranteed benefit to adults in need, seniors, children, and people with disabilities. Together, our joint efforts made a critical difference to #SaveMedicaid in 2017. We successfully defeated legislation that included plans to fund Medicaid via capped block grants, which would have cut federal Medicaid spending by $772 billion over ten years. We hope you’ll join us again now in contacting lawmakers to prevent CMS from making harmful changes to Medicaid.

Ways You Can Take Action:
As part of our continuing efforts to safeguard Medicaid and ensure it provides coverage that is affordable, accessible and adequate for vulnerable individuals nationwide, we suggest below several actions you can take to influence decision makers’ opinions both at the federal and state level:
  • Option 1: Lutheran Services in America sent a letter to Administrator Verma on January 31, 2020 expressing our continued opposition to proposed policies that would cut coverage for Medicaid beneficiaries. Feel free to draw any messaging from this correspondence which would be helpful to you as you reach out to any of the officials mentioned below.
    • Contact key officials in your state and make your voice heard:  Reach out to state officials including your state’s health agency and Governor. These key stakeholders soon will be in a position to decide whether to submit a waiver request under this new proposal. If you need assistance identifying or contacting your state officials, please let us know and we will be glad to help.
    • Contact your elected Federal officials: While Congress does not have direct decision-making authority on this issue at this time, dozens of lawmakers contacted CMS on January 29 to express their disapproval. These lawmakers are in a position to use their oversight and appropriations powers to safeguard Medicaid coverage going forward. As such, we urge you to contact U.S. Senators from your state and your U.S. Representative.
  • Option 2: Write to your Representative and Senators through our advocacy tool where we provide suggested language, emphasizing the need to safeguard Medicaid from harmful cuts or caps in funding. You may wish to add a personalized message about how Medicaid cuts would impact your organization.
  • Option 3: Contact your lawmakers by phone using the suggested talking points below. You can find your lawmakers and their phone numbers here. Suggested messaging you may wish to use during your call:
    • “Given our commitment to working with so many of our state’s most vulnerable people, our organization urges lawmakers to urge CMS to NOT use waivers to cut Medicaid or remove so many people in America from Medicaid as CMS officials currently propose. This change will have the power to dramatically affect the health and lives of the over 17 million people in 37 states covered under Medicaid expansion. People in our state deserve better.”
  • Option 4: Since lawmakers’ staff consistently monitor their social media pages, reaching out via their Twitter pages is also useful.
    • You can find your lawmakers and their twitter handles here.
    • Two suggested tweets:
      • [Insert your lawmaker’s Twitter handle here] I urge you to tell CMS not to use the waiver process to cut #Medicaid coverage for vulnerable people.
      • [Insert your lawmaker’s Twitter handle here] Congress should reject proposals to use the waiver process to remove people from #Medicaid.

Be assured that we are continuing our outreach to CMS, the rest of the Administration, and lawmakers to urge them not to use the waiver process to cut Medicaid coverage for vulnerable people. We are closely monitoring this situation and will keep you informed in the days ahead and will continue to share additional messaging and action items.

Need more information? Please contact Sarah Dobson, Director of Public Policy and Advocacy, at or 202-499-5832.