Research / Health & Human Services

Policy Analysis | August 2019

Approved 1115 Medicaid Demonstrations in the South

Roger Moore, Policy Analyst

Under Section 1115 of the Social Security Act, the U.S. Department of Health and Human Services has the authority to waive specific provisions of major health and welfare programs, including Medicaid and the Children’s Health Insurance Program (CHIP). Section 1115 waivers give states the flexibility to implement experimental or pilot projects, frequently referred to as “demonstrations,” to test new approaches to Medicaid and CHIP that differ from federal rules. Approved demonstrations must be budget-neutral, meaning any changes to services or coverage cannot exceed existing costs. Additionally, all approved demonstrations are subject to specific rules regarding transparency and evaluation. Public notice and comment periods at both the state and federal levels are required before Section 1115 waivers are approved.1

In the SLC region, 10 states have approved Section 1115 waivers as of August 2019, for a total of 13 waivers (two each in Arkansas, Florida and Mississippi). Approved Southern state demonstrations focus on five key areas of Medicaid/CHIP services and coverage:

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Comparative Data Reports | August 2019

Adult Correctional Systems, Education, Medicaid and Transportation

Comparative Data Reports (CDRs) are prepared annually by select SLC states’ fiscal research departments. These reports track revenue sources, appropriations levels, performance measures, and a multitude of other metrics in Southern states. A useful tool for legislators and legislative staff alike, CDRs are available for adult correctional systems, education, Medicaid, and transportation.

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Policy Analysis | May 2019

Vaping and Electronic Cigarette Legislation (2019)

Roger Moore, Policy Analyst

Electronic cigarette usage has surged in recent years, with increased rates among youth and young adults posing a particularly worrisome challenge for public health officials. According to the Centers for Disease Control and Prevention (CDC), approximately 4.9 million middle and high school students were users of tobacco products in 2018, an increase of 1.3 million from 2017. The increase – driven mostly by the growth of electronic cigarettes – impedes successful efforts by states in recent years to reduce youth tobacco usage. More than a quarter of high school students and about 7 percent of middle school students reported using tobacco products in 2018, with electronic cigarettes the most common among both demographics. Electronic cigarettes have benefits for adults using them as complete substitutes for regular cigarettes; however, the CDC and U.S. Surgeon General both warn they should not be used by youth, young adults, pregnant women and adults who do not smoke. U.S. health agencies acknowledge that further studies are needed to understand the long-term health effects of electronic cigarettes.1

In an effort to address concerns surrounding the rising popularity of vaping and electronic cigarette products among youth and young adults, many states across the South introduced and, in several cases, enacted related legislation in 2019. The legislation generally focuses on three areas:

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Katrina Shealy

South Carolina

Vice Chair
Representative Fredrick Love, Arkansas

Fredrick J. Love


Past Chair

(former) Senator
Doug Overbey


Roger Moore

Roger Moore
Policy Analyst

Ensuring the public’s general welfare and protection are among states’ most pressing concerns, with both areas constituting considerable shares of state budgets. The SLC Human Services & Public Safety Committee has a broad agenda, which takes into account the challenges states face in the areas of human services and corrections, as well as policies and programs that address them. The committee frequently undertakes assessments of pressing health issues including the national opioid crisis, organ donations and long-term care, as well as various corrections issues such as aging inmate populations, female offenders and mental health parity in prisons.

More SLC Research into Health & Human Services

Policy Analysis | April 2019

School Counselor Legislation in the South

SLC Regional Resource | April 2019

Surprise Medical Billing in the South: A Balancing Act

Policy Analysis | April 2019

Federal Legislation on Rural Hospitals

Policy Analysis | January 2019

Medical Marijuana Laws in Southern States

Other | January 2019

Issues to Watch - 2019

SLC Issue Brief | October 2018

The Growth of Synthetic Opioids in the South

Policy Analysis | September 2018

Poverty Statistics for Southern States

Policy Analysis | August 2018

Suicide Rates in the South

SLC Regional Resource | May 2018

Opioids and Organ Donations: A Tale of Two Crises

SLC Special Series Report | December 2017

Long-Term Care in the South (Part II)

Comparative Data Reports | July 2017

Adult Correctional Systems, Education and Medicaid

Policy Analysis | April 2017

Cross-State Health Insurance Policies

SLC Special Series Report | January 2017

Long-Term Care in the South (Part 1)

SLC Regional Resource | May 2016

Spread of Zika: Impact on Southern States

Policy Analysis | May 2016

Recent numbers on Zika Infections

SLC Regional Resource | March 2016

Heroin Epidemic in SLC Member States: Finding Solutions

Webinar | December 2015

SLC State Pensions: Latest Developments

SLC Regional Resource | April 2015

Vapor Rising: E-Cigarettes in the SLC States

Policy Analysis | January 2015

Departments of Elder Abuse and/or Aging

Webinar | October 2014

Food Safety Modernization Act

Policy Analysis | August 2014

Southern States' Medicaid Spending

SLC Regional Resource | March 2014

A Special Condition: Medical Marijuana in SLC States

Policy Analysis | October 2013

Southern States' Medicaid HMO Plans

Comparative Data Reports | July 2012

Medicaid, Revenue and Transportation

Policy Analysis | June 2012

Grandparental Visitation Rights

Policy Analysis | March 2012

Organization of Public Health Services

Policy Analysis | September 2011

Prospective Changes in Long-Term Care Policies

Policy Analysis | May 2011

A Prescription Drug Epidemic

Policy Analysis | November 2010

Economic Impact of the Great Recession

SLC Regional Resource | July 2010

Meth: Resurgence in the South

Policy Analysis | March 2010

Southern States' Health Insurance Rates

SLC Regional Resource | January 2010

Autism and Schools

Policy Analysis | January 2010

Drug Recycling Programs

Policy Analysis | October 2009

Southern States' SCHIP Programs

SLC Issue Alert | January 2009

An HIV Epidemic?

Policy Analysis | March 2008

Prescription Drug Reuse and Recycling

Comparative Data Reports | November 2007

Adult Correctional Systems, Education, Medicaid and Revenue

SLC Regional Resource | April 2001

Methamphetamine Production and Abuse in Southern States

Comparative Data Reports | November 2000

Adult Correctional Systems and Medicaid