What is a HIFA waiver?
A. A Health Insurance Flexibility and Accountability (HIFA) waiver is a type of Section 1115 waiver created by the Bush Administration in August 2001. HIFA waivers were purportedly intended to extend health coverage to people who are uninsured without increasing federal Medicaid funding. To do this, the Administration’s HIFA guidance announced that states could find “savings” in their Medicaid programs by cutting services or raising out-of-pocket costs for people who already had Medicaid and then use this “savings” to expand coverage to the uninsured. States have also been encouraged to establish premium assistance programs to help people buy employer-sponsored coverage, to offer Medicaid coverage with a significantly reduced benefit package, and to establish higher cost-sharing for the people who are newly eligible for the program. The Administration claims that HIFA was designed to encourage states to expand Medicaid and SCHIP coverage to adults with incomes below 200 percent of the
