Overview of Section 1135 and Section 1115 Waivers

On March 13, President Trump issued an emergency declaration under both the National Emergencies Act and the Robert T. Stafford Act concerning the Novel Coronavirus and COVID19. Department of Health and Human Services (HHS) Secretary Azar had declared a public health emergency under Section 319 of the Public Health Services Act on January 31.

The president’s declaration empowers the HHS secretary to authorize the Centers for Medicare & Medicaid Services (CMS) to take proactive steps to address key health system needs through Section 1135 waivers and Section 1115 demonstrations for disaster response. The purpose of the waiver authority is to allow a temporary relaxation of certain regulatory requirements so that CMS and states can ensure that sufficient health care services are available to meet the needs of individuals when and where an emergency is experienced. In determining what action may be needed, below are considerations for governors on the flexibilities available to states through section 1135 waivers and section 1115 demonstrations.

All NGA COVID-19 memos can be found here, or visit COVID-19: What You Need To Know for current information on actions States/Territories are taking to address the COVID-19 pandemic; as well as advocacy, policy, and guidance documents for protecting public health and the economy.