The NCSL Blog


By Margaret Wile

During the hustle and bustle of the holiday season, the state of Mississippi received a gift that will keep giving, at least for the next 10 years.

pregnant womanIt is the first 10-year extension of a waiver under Medicaid. Mississippi received a letter from the Centers for Medicare and Medicaid Services (CMS) on Dec. 28, 2017, stating the state’s 1115 waiver for family planning services had been accepted.

“We were very surprised and thrilled to learn we received the 10-year extension of the Family Planning Waiver by CMS last month,” said Dorthy Young, Mississippi’s deputy administrator for health services at the division of Medicaid.

“The overall goal of this waiver is to improve birth spacing and outcomes among Medicaid beneficiaries, thereby reducing associated pregnancy and birth-related Medicaid costs. The Family Planning Waiver is designed to achieve this through a number of strategies:

  • Increasing access to and use of family planning and family planning-related services by women and men.
  • Improving the access to and use of Medicaid family planning services by women who have received Medicaid pregnancy-related services.
  • Improving birth outcomes and the health of women by lengthening intervals between births.

Section 1115 of the Social Security Act gives the secretary of Health and Human Services authority to waive provisions of the law to encourage state innovation and experimental demonstrations in Medicaid programs. States have tested a wide range of policy approaches under 1115 waivers, including offering coverage to otherwise ineligible populations, providing services not typically covered by Medicaid, experimenting with cost sharing and other payment reforms, and implementing changes to the delivery system.

As of Jan. 9, 2018, 34 states had at least one approved 1115 waiver and 22 states had one or more pending waivers. Each waiver is unique and states use them for different purposes.

Mississippi’s 1115 waiver, The Mississippi Family Planning Medicaid Waiver, will allow the state to provide coverage of family planning services to both men and women with an annual income of up to 194 percent of the federal poverty level (FPL) who are not otherwise insured.

Mississippi is one of eight states participating in a yearlong state team project to improve maternal and child health. The project, Learning Collaborative on Improving Quality and Access to Care in Maternal and Child Health, is supported by grants from the Maternal and Child Health Bureau in the Health Resources and Services Administration.

NCSL’s national partners include the American Academy of Pediatrics (AAP), the Association of Maternal and Child Health Programs (AMCHP), the Association of State and Territorial Health Officials (ASTHO), the National Academy for State Health Policy (NASHP) and the National Governors Association (NGA).

The state teams made up of legislators, state health officials, maternal and child health directors, Medicaid officials and pediatricians, convened in Baltimore in May 2017 for a multi-state invitational meeting on improving maternal and child's' health (MCH).

The three-day conference provided state teams the opportunity to listen to a variety of experts who spoke on increasing continuity of coverage and care for pregnant women and children, improving systems of care for children and youth with special health care needs, and implementing the Bright Futures Guidelines, created by AAP, these guidelines provide pediatricians with a framework for well-child care from birth to age 21.

The state teams discussed their state’s top MCH issues during breakout sessions and constructed team action plans based on what they learned and knew about their own states. See additional information about the conference’s agenda and presentations from expert panelists. 

Since the meeting last May, the state teams continue to connect through monthly calls and emails to continue work on their action plans and improve the health and wellbeing of the maternal and child populations in their states.

Young, a member of this Mississippi team, stated that “In addition to the extension, we are very grateful to have been awarded a number of technical assistance grants by CMS in the last couple of years that helped [us] substantially improve the collection and reporting of maternal/child health-related data. That assistance and the 10-year extension by CMS have directly enhanced services and outcomes for our beneficiaries and providers.”

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Margaret Wile is a policy specialist in NCSL's Health program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.