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The Advocacy Challenge of a Lifetime

Shaping Medicaid Waivers to Serve the Poor

By Jane Perkins & Michele Melden

In recent months, states have begun using the Social Security Act's "Section 1115" experimental waiver provision to expand Medicaid to additional uninsured groups and to mandate prepaid managed care for the poor. Legal services attorneys face a twofold challenge: to represent our uninsured clients to assure that health care coverage is expanded carefully, while at the same time representing our Medicaid clients to avoid harmful Medicaid cutbacks and inadequate, unmonitored managed care plans.

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