Waiver amendments should be available on this site
As a long-time “waiver watcher”, I commend you on your efforts to create greater transparency and more meaningful public input on Medicaid waivers. As you know, waivers and amendments to waivers often have a significant impact on the health and well-being of children, families and other individuals. These decisions should be subjected to full public scrutiny - not hidden behind closed doors. You have made an important first step toward the goal of opening the door on what can be an opaque process. It’s important to note that many consequential changes to Medicaid occur through amendments to waivers. In some case, the changes can even be greater than was effected through the underlying waiver itself. To move closer to that laudable goal of a more transparent decision-making process, we “waiver watchers” strongly recommend that waiver amendments be subjected to the same public notice and comment requirements as initial applications. We also recommend that useful information, such as the question and answer dialogue between the state and federal government, be posted as it is written rather than after the waiver has been approved. On behalf of Georgetown University’s Center for Children and Families and 25 national groups that support these changes, I want to thank you for the opportunity to comment on the great job you have done so far and for the opportunity to provide our recommendations for improvements.