CMS has approved over 200 requests for state relief in response to the COVID-19 pandemic, including recent approvals for Alaska, Iowa, Hawaii, New Jersey, North Carolina, Pennsylvania, Rhode Island, Utah, and Virginia. These approvals help to ensure that states have the tools they need to combat COVID-19. This is done through a wide variety of waivers, amendments, and Medicaid state plan flexibilities, including support for programs that care for the elderly and people with disabilities. CMS also developed a toolkit to expedite the application and review of each request and has approved these requests in record time. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.