Innovation Waivers Allow States to Pursue Own Brand of Health Reform
<p>Depending on their priorities, states can propose waivers under Section 1332 of the Affordable Care Act (ACA) to pursue their own approaches to expanding coverage or to make smaller, targeted changes. States must only demonstrate that coverage will remain as accessible, comprehensive, and affordable as before the waiver, and that the proposed revisions won’t add to the federal deficit.</p><p>A new brief from The Commonwealth Fund and the Robert Wood Johnson Foundation State Health Reform Assistance Network examines the requirements of the ACA’s State Innovation Waiver program, which goes into effect in less than two years, and explores how states might take advantage of its opportunities to:</p>
<ul>
<li>modify the rules governing covered benefits and the subsidies available through the marketplaces</li>
<li>replace their marketplace or health plan certification process with alternative ways of providing plan choice, determining eligibility for subsidies, and enrolling consumers in coverage</li>
<li>change or eliminate the individual or employer mandate.</li>
</ul>
<p>Authors Deborah Bachrach, Joel Ario, and Hailey Davis of Manatt, Phelps & Phillips say the waivers “involve a delicate balancing act”—allowing states broad latitude to experiment, while also requiring they meet the law’s coverage and affordability goals.</p>