Maryland and Louisiana both recently submitted Section 1332 “innovation” waivers under the Affordable Care Act (ACA). These waivers allow states to modify key parts of the law, so long as they stay true to its goals and consumer protections. According to the ACA, a waiver can’t be granted unless the health insurance that results is at least as comprehensive and affordable as before, while covering a comparable number of residents. The waiver also cannot add to the federal deficit.