HHS And Treasury Release Substantive Guidance On ACA State Innovation Waivers

Implementing Health Reform. Section 1332 of the Affordable Care Act provides for waivers for state innovation. The idea behind this provision is that if individual states can find a better way of reaching the goals of the ACA, they should be allowed to try. Under section 1332, states may, for years beginning after January 1, 2017, apply to the Departments of Health and Human Services and Treasury for a waiver from certain provisions of the ACA, including the individual and employer mandates, the qualified health plan requirements, the actuarial value and essential health benefit requirements, and the premium and small business tax credit and cost-sharing reduction provisions. Other provisions of the ACA, including the prohibitions against imposing preexisting condition requirements or underwriting based on health status, cannot be waived. To be granted a waiver, states must demonstrate that their alternative proposal will stay within certain guardrails. Specifically, a state must show that its proposal will: provide coverage at least as comprehensive as that provided under the ACA, provide coverage and protection against excessive out-of-pocket expenditures at least as affordable as that provided under the ACA, cover a number of residents at least a comparable to the number who would be covered under the ACA, and not increase the federal deficit. A waiver proposal must be authorized by state legislation and be developed through a public process. Waivers can be granted for ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Medicaid and CHIP States vulnerable populations Source Type: blogs