KFF Updates Its Section 1115 Medicaid Waiver Tracker

The Kaiser Family Foundation (KFF), a nonpartisan health policy research organization, maintains an ongoing Medicaid Waiver Tracker that lists every state's approved and pending Section 1115 waivers, and the resource was refreshed on November 2, 2026. A Section 1115 waiver is a federal approval that lets a state test Medicaid rules that differ from standard federal requirements, covering changes to eligibility, covered benefits, and social determinants of health programs such as housing or nutrition support tied to Medicaid coverage. For readers of Senior Plan Path, this tracker matters because many of the waivers it lists directly affect low-income seniors, people who qualify for both Medicare and Medicaid (often called dual eligibles), and anyone relying on Medicaid-funded home and community-based services (HCBS) to stay out of a nursing facility.

Because Section 1115 waivers are approved state by state and expire or renew on different schedules, the rules that apply to a Medicaid beneficiary in one state can look very different from the rules in a neighboring state. KFF's tracker is designed as a reference tool, not a single news event, so there is no one nationwide rule change to report. Instead, it is a running record that families and caregivers can check against their own state's Medicaid program.

Why This Affects Seniors Specifically

Most people think of Medicaid as a program for low-income families, but it is also the primary payer for long-term nursing home care in the United States and a major funder of in-home personal care services for older adults. Section 1115 waivers frequently touch the parts of Medicaid that seniors depend on most: HCBS waiver slots that let someone receive care at home instead of in a facility, eligibility rules for people who are also enrolled in Medicare, and benefit packages for dual-eligible beneficiaries. According to KFF's tracker description, the waivers it catalogs include both expansions, such as broader HCBS access or new benefits addressing housing and food insecurity, and restrictions, such as tighter eligibility or work-related conditions for certain enrollees. Historically, work requirements tied to Section 1115 waivers have generally exempted people 65 and older, but they can still affect a senior's household if a spouse or caregiver under 65 is also on Medicaid, since a change to that person's eligibility can ripple into the household's overall coverage and finances.

For dual-eligible seniors in particular, Medicaid waiver changes can interact with Medicare enrollment decisions. Someone enrolled in a Dual Eligible Special Needs Plan (D-SNP), a type of Medicare Advantage plan built for people who have both Medicare and Medicaid, may see their benefit package shift if their state alters Medicaid eligibility rules or covered services under a waiver. That makes it worth checking both programs together rather than assuming a Medicare enrollment decision is independent of what Medicaid is doing.

Key Takeaway

Section 1115 Medicaid waivers vary by state and change on different timelines, so a senior's coverage, HCBS waitlist status, or dual-eligible benefits can shift without a single national announcement. Checking your state Medicaid agency's current waiver status, not just national headlines, is the only reliable way to know what applies to you in 2026.

What Seniors and Caregivers Should Check Next

Three practical steps can help readers stay ahead of waiver-driven changes. First, confirm your state's current Section 1115 waiver status directly through KFF's tracker or your state Medicaid agency's website, since approval dates, renewal dates, and the specific provisions in effect differ by state. Second, if you or a family member relies on home and community-based services, ask your state Medicaid office or care coordinator whether the HCBS waiver you use has a waitlist, a renewed budget, or a pending change, since these waivers are a common target of both expansions and restrictions under Section 1115. Third, if you are dual eligible or helping a parent manage both Medicare and Medicaid, review your plan's benefits at your next enrollment opportunity and ask a licensed insurance agent how a state-level Medicaid change could affect a D-SNP or other Medicare Advantage plan you are considering.

None of this requires immediate action for most seniors, since many waiver provisions phase in gradually and nursing home and HCBS eligibility rules change less often than other parts of Medicaid. But because the rules are state-specific and the federal approval process for these waivers can take months or years, the safest approach is to verify your own state's status rather than relying on general news about Medicaid policy. If you are unsure how a waiver in your state applies to your situation, a licensed Medicare or Medicaid counselor, often available free through your State Health Insurance Assistance Program (SHIP), can walk through your specific coverage and eligibility questions.