Initial Considerations for Adopting the New 1915c Waiver Design as Enacted in the One Big Beautiful Bill Act (HR1)

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Rockefeller Institute of Government

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Feb 25, 2026, 1:33:23 PM (2 days ago) Feb 25
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A new 1915c waiver becomes effective for states in January 2028. In preparing, New York State should keep these considerations in mind.

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Initial Considerations for Adopting the New 1915c Waiver Design as Enacted in HR1

Changes in the One Big Beautiful Bill Act (OBBBA, or HR1) passed last summer included adjustments to a less discussed provision: 1915c waivers. These types of Medicaid waivers are typically used by states to provide long-term services and supports. Although the Centers for Medicare and Medicaid Services (CMS) has not yet provided much guidance about the new 1915c waiver opportunity, which becomes effective for states in January 2028, there is still the potential it will provide new flexibility for the way states use the waiver to cover those who need ongoing services and supports to maintain their independence in the community, write guest author Jillian Kirby Bronner and Senior Fellow for Health Policy Courtney Burke. In a new analysis on the waiver, Kirby Bronner and Burke outline six policy considerations that can ensure sustainable, high-quality care for New York's growing aging population. Continue Reading...

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If you have any questions or comments about our content or are seeking more information, please contact Joel Tirado at joel....@rock.suny.edu.

About the Rockefeller Institute of Government

The Rockefeller Institute of Government is the public policy research arm of the State University of New York. The Institute conducts cutting-edge research and analysis to inform lasting solutions to the problems facing New York State and the nation. 

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