Waivers available under Section 1332 of the Affordable Care Act (ACA) take effect as early as January 1, 2017, and offer great potential of flexibility for states in achieving the goals of the ACA. They require legislative authorization, substantial public engagement, and negotiation with the federal government, thus presenting additional time and resource challenges for states.
Now is the time for states to begin thinking through possible ideas if they want them to take effect in January 2017. States could choose to modify the ACA’s coverage mandates for individuals or employers, change the benefit requirements, reallocate the subsidies available to purchase coverage, or even opt out of having an Exchange, as long as the overarching goals of the ACA are still met. A
presentation, prepared by Manatt Health Solutions with support from the State Health Reform Assistance Network (State Network), provides an overview of the basics of Section 1332 waivers, including what can and cannot be waived, the statutory criteria under which the federal government will approve a waiver, the process for obtaining a waiver, and possible opportunities for state innovation.
This new
issue brief, cosponsored by the State Network and the Commonwealth Fund, further describes how states may use the Section 1332 Waivers to reallocate subsidies, expand or streamline their marketplaces, replace or modify the mandates, and otherwise pursue their own brand of reform tailored to local market conditions and political preferences.
