Programs › 93.423
Assistance listing · 93.423
1332 State Innovation Waivers
Federal financial assistance obligated under listing 93.423, the organisations that receive it and where it goes.
USAspending caveat. Figures are obligations reported by federal agencies to USAspending.gov, not payments. In USAspending's words: "An outlay occurs when federal money is actually paid out, not just promised to be paid ('obligated')." "Every agency has a Senior Accountable Official who must officially certify that the quarterly financial data submitted by their agency is accurate and complete." "If there are any discrepancies in procurement data, FPDS is the authoritative source." Contract data for the Department of Defense and the U.S. Army Corps of Engineers is published with a 90-day delay. Data loaded 30 Sep 2026.
Federal agencies obligated $12B in awards under assistance listing 93.423, 1332 State Innovation Waivers, in FY2026, and $44B over the five fiscal years since FY2023; the program ranks 16 of 988 on this site.
Obligations were down 26% on FY2025 ($16B), with $0 so far in FY2027.
The largest recipient organisations over FY2022–FY2025 were NYS Department of Health ($22B), Department of Insurance of the State of Georgia ($2.6B) and Maryland Health Benefit Exchange ($1.9B).
By place of performance, the most money went to NY, GA and MD.
Obligations by fiscal year
Compared with the largest program FY2026
| Measure | This program | Grants to States for Medicaid | All assistance |
|---|---|---|---|
| Obligations, FY2026 | $12B | $722B | $4.4T |
| Five-year total | $44B | $2.6T | $17T |
| Share of all assistance obligations, five years | 0.3% | 15.2% | 100% |
Largest recipients obligations, FY2022–FY2025
Awarding agencies $1.0M+ awards
Where the money goes
Largest awards since FY2023
| Recipient | Awarding agency | Type | Award value | Begun | Place | Record |
|---|---|---|---|---|---|---|
| NYS Department of Health | Department of Health and Human ServicesCenters for Medicare and Medicaid Services | GrantProject Grant (B) | $30B | 23 Apr 2024 | NY | USAspending |
| State Corporation Commission | Department of Health and Human ServicesCenters for Medicare and Medicaid Services | GrantBlock Grant (a) | $1.6B | 23 Jun 2023 | VA | USAspending |
| Idaho Individual High Risk Reinsurance Pool | Department of Health and Human ServicesCenters for Medicare and Medicaid Services | GrantProject Grant (B) | $411M | 23 Jun 2023 | ID | USAspending |
| Nevada Health Authority | Department of Health and Human ServicesCenters for Medicare and Medicaid Services | GrantBlock Grant (a) | $29M | 9 Jul 2026 | NV | USAspending |
Other programs numbered 93.xxx
- 93.778 Grants to States for Medicaid $2.6T
- 93.767 Children's Health Insurance Program $83B
- 93.558 Temporary Assistance for Needy Families $68B
- 93.600 Head Start $46B
- 93.575 Child Care and Development Block Grant $33B
- 93.658 Foster Care Title IV-E $20B
- 93.568 Low-Income Home Energy Assistance $18B
- 93.224 Health Center Program $17B
- 93.563 Child Support Services $17B
- 93.855 Allergy and Infectious Diseases Research $16B
- 93.866 Aging Research $15B
- 93.659 Adoption Assistance $15B
- 93.210 Tribal Self-Governance Program: IHS Compacts/Funding Agreements $15B
- 93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $14B
- 93.837 Cardiovascular Diseases Research $13B
- 93.859 Biomedical Research and Research Training $12B
- 93.566 Refugee and Entrant Assistance State/Replacement Designee Administered Programs $12B
- 93.798 Rural Health Transformation Program $10B
- 93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $8.8B
- 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $8.0B
- 93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $7.5B
- 93.959 Block Grants for Prevention and Treatment of Substance Abuse $7.4B
- 93.676 Unaccompanied Alien Children Program $7.3B
- 93.242 Mental Health Research Grants $7.1B
Questions and answers
How much is obligated under assistance listing 93.423?
$12B in FY2026 and $44B over the five fiscal years since FY2023, counting every award type recorded under the listing (grants, direct payments, loan subsidy cost, insurance and other assistance). Obligations are commitments, not payments.
Who receives the most under 1332 State Innovation Waivers?
NYS Department of Health ($22B), Department of Insurance of the State of Georgia ($2.6B), Maryland Health Benefit Exchange ($1.9B), Banking and Insurance, New Jersey Department of ($1.9B), State Corporation Commission ($1.3B). Individuals are never listed; where a program pays individuals, USAspending records aggregated rows that appear here as "not shown".
What is an assistance listing (CFDA) number?
A five-digit number that identifies a federal financial assistance program on SAM.gov (formerly the Catalog of Federal Domestic Assistance). Every grant, loan, direct payment or other assistance award on USAspending carries one; contracts do not.
Provenance
Source: USAspending.gov API v2, spending by category (assistance listing) by fiscal year, recipient cross-tabulation for FY2022–FY2025 and award search, loaded 30 Sep 2026. State figures come from each state's top-100 listing table, so small amounts in a state may be missing. See methodology.