What’s the difference between a Medicaid waiver and a SCHIP waiver?

A. A Medicaid waiver changes a state’s Medicaid program, while a SCHIP waiver changes a state’s Children’s Health Insurance Program (SCHIP). Simple, right?

Wrong. The difference between these kinds of waivers really has to do with where the program funding comes from. If a state is seeking to expand health coverage with Medicaid funds or to cut Medicaid in ways not otherwise allowed by law, it needs a Medicaid waiver.

If it is seeking to use SCHIP funds to expand coverage to a new group of people (e.g. , adults), it needs a SCHIP waiver. For example, in the past, some states that did not use all of their SCHIP funds for children’s health coverage sought SCHIP waivers to finance expansions for the parents of SCHIP- and Medicaid-eligible children and sometimes for childless adults. (Note: Recent legislation prohibits states from seeking new SCHIP waivers to use SCHIP funds to expand coverage of childless adults.

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