10/21/2025
PUBLIC NOTICE:
Michigan Department of Health and Human Services
Health Services
Flint, Michigan Section 1115 Demonstration Waiver Extension Application
In accordance with 42 CFR § 431.408, the Michigan Department of Health and Human Services (MDHHS) is hereby providing notice that it will be holding a public hearing and comment period seeking input on the submission of its demonstration waiver extension application to the Centers for Medicare & Medicaid Services (CMS). MDHHS is seeking a 5-year extension of the Flint Michigan Section 1115 Demonstration, also referred to as the Flint Waiver, which is set to expire on September 30, 2026.
The waiver extension application maintains expanded eligibility for individuals served by the Flint water system between April 1, 2014, and September 30, 2025.
Flint Waiver Demonstration Description and Objectives
In 2016, CMS approved Michigan’s application to establish a five-year Medicaid demonstration entitled “Flint Michigan Section 1115 Demonstration” (Project Number 11-W-00302/5), in response to the public health emergency of lead exposure related to the Flint water system. The demonstration expanded coverage to low-income children up to age 21 years and pregnant women served by the Flint water system during a state-specified time period. The Flint Waiver was established in part to address resulting health effects and improve health outcomes.
The overarching goal of the MDHHS waiver application is to “identify and address any physical or behavioral health issues associated with actual or potential exposure to lead hazards.” The Demonstration expands eligibility of all Medicaid benefits for low-income children (up to age 21 including children born to eligible pregnant women) and pregnant women (through twelve months post-delivery) served by the Flint water region from April 1, 2014, through September 30, 2025. The specific eligibility modifications included:
• Increase income threshold to offer coverage to children in households with incomes from 212% federal poverty level (FPL) up to and including 400% FPL.
• Increase income threshold to offer coverage to pregnant women in households with incomes from 195% FPL up to and including 400% FPL.
• Eliminate cost sharing and Medicaid premiums for eligible children and pregnant women served by the Flint water system.
Targeted Case Management (TCM) services are available to all eligible beneficiaries up to age 21, pregnant women, and women in their postpartum period, who were eligible and enrolled under the state plan while pregnant (including during a period of retroactive eligibility) through the last day of the month in which a 12 month postpartum period (beginning on the last day of the pregnancy) ends served by the Flint water system as of April 1, 2014.
Public Hearing, Review of Documents, and Comment Submission
In compliance with the public notice process as specified in 42 CFR 431.408, public hearings are scheduled for the date, time and location below:
October 20, 2025, from 5:30 p.m. to 7:30 p.m.
MSU College of Human Medicine
200 East 1st Street
Flint, MI 48502
October 21, 2025, from 1:00 p.m. to 3:00 p.m.
Virtual Hearing hosted by Michigan Department of Health and Human Services
Registration Link (not required for attendance): https://somdhhs.adobeconnect.com/ezxmx6uk1aoc/event/registration.html
Event Link: https://somdhhs.adobeconnect.com/r379h66yrlro/
Question Submission Link: https://bphasa.qualtrics.com/jfe/form/SV_8HVY3lkwZ1i8usS
These public hearings will provide an overview and discussion of the demonstration waiver extension. All interested parties will be provided the opportunity to provide comments on the Flint Waiver demonstration waiver extension application.
A copy of the complete §1115 waiver application, stakeholder notice, and waiver summary is available online at https://www.michigan.gov/mdhhs/assistance-programs/section-1115-waiver-medicaid-eligibility-for-flint-residents. You may also request a hard copy of the complete §1115 waiver application, stakeholder notice, and waiver summary by contacting [email protected]. You may also submit comments regarding the waiver to the address below or by email to [email protected].
Michigan Department of Health and Human Services
Health Services
Medicaid Policy Section
P.O. Box 30479
Lansing, MI 48909-7979
All comments on this topic should include a “Section 1115 – Flint Waiver Extension” reference somewhere in the written submission or the subject line if by e-mail. Comments will be accepted until November 16, 2025.
The most powerful, simple and trusted way to gather experience data. Start your journey to experience management and try a free account today.
