Barbara Coulter Edwards, MPP, Health Management Associates

Susan P. Garcia, Health Management Associates

Aimee E. Lashbrook, JD, MHSA, Health Management Associates

Lynda Flowers, AARP Public Policy Institute

October 2007

States now have more discretion in changing Medicaid policies, including changing benefits and imposing cost-sharing on beneficiaries. Consumers and advocates want to make sure they have a voice in what these changes will be. This AARP Public Policy Institute Issue Paper, by Barbara Coulter Edwards, Susan P. Garcia, and Aimee E. Lashbrook of Health Management Associates and Lynda Flowers of the Public Policy Institute, examines the processes states have in place to solicit public input into Medicaid policy changes developed and implemented through Section 1115 waivers or State Plan Amendments (SPAs). Recommendations are offered on how federal and state governments can improve or enhance existing opportunities for public involvement in the Medicaid policymaking process. In order to maximize the effectiveness of these opportunities, they must be available early in the policymaking process, before the state has committed to a particular policy position. Advocates are advised to develop and nurture strong, ongoing relationships with federal and state officials. (80 pages)