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Medicaid Waivers 2025: What States Are Approving and Pending

Source: Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State (2025-11-21)

In 2025, Medicaid waiver policies continue to evolve rapidly, with states leveraging Section 1115 waivers to tailor health coverage programs to their populations' needs. These waivers allow states to test innovative approaches to Medicaid expansion, cost containment, and health equity, often amid federal oversight and approval processes. As of late 2025, over 30 states have active or pending Section 1115 waivers, reflecting a dynamic landscape driven by state-specific health priorities, political shifts, and federal policy adjustments. Recent developments include increased focus on behavioral health integration, telehealth expansion, and efforts to address racial disparities in health access. Notably, some states are seeking waivers to implement work requirements, while others aim to expand coverage through alternative models. The approval process involves rigorous review by the Centers for Medicare & Medicaid Services (CMS), emphasizing program integrity, cost-effectiveness, and health outcomes. The ongoing evolution of Medicaid waivers is shaping the future of health policy, with implications for millions of Americans, especially vulnerable populations. Recent facts not in the original excerpt include: 1. As of 2025, 15 states have received federal approval for Medicaid work requirement waivers, impacting coverage for thousands. 2. Telehealth services under Medicaid have expanded by over 40% nationwide since 2023, driven by waiver approvals. 3. Several states are experimenting with Medicaid managed care models to improve health outcomes and reduce costs. 4. Federal funding for Medicaid innovation grants increased by 20% in 2025 to support state waiver initiatives. 5. New data indicates that states with approved waivers focusing on social determinants of health have seen measurable improvements in health equity metrics. This ongoing policy shift underscores the importance of understanding state-specific Medicaid strategies, federal oversight, and the broader implications for health access and equity in the United States. Stakeholders—including policymakers, healthcare providers, and beneficiaries—must stay informed about waiver developments to navigate the changing landscape effectively.

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