State health coverage innovation and Section 1332 waivers
Implications for states
Additional Affordable Care Act (ACA) provisions are scheduled to go into effect in the coming years. Section 1332 is a provision that will allow states to apply for a State Innovation Waiver to pursue alternative and innovative strategies for ensuring that residents have access to high-quality, affordable health insurance. This health policy brief explores a number of potential waiver-associated coverage alternatives for consideration.
States can take advantage of innovative alternatives for health care coverage
Although states and the federal government have implemented most Affordable Care Act (ACA) provisions, a few are scheduled to go into effect in the coming years. One such provision is Section 1332 State Innovation Waivers,1 which allows states to pursue alternative and innovative strategies for ensuring that residents have access to high-quality, affordable health insurance as long as they meet certain requirements. Within the constraints of Section 1332, states have numerous options for revamping their current approaches to providing health coverage to individuals and families. If approved, the waivers can go into effect beginning January 1, 2017. To implement reforms next year and take advantage of realizing innovative alternatives for health care coverage, states should consider acting now.
1 Public Law 111-148: Section 1332 (codified as 42 U.S.C. 18052)
What are Section 1332 waivers?
During ACA congressional negotiations, Section 1332 waivers were envisioned as a way for a state to achieve ACA coverage goals by pursuing alternative approaches that might better suit its specific health care market needs.
States can apply for Section 1332 waivers in 2016 as long as they allow sufficient time for proposal review and implementation. If a state’s application is approved, the waiver can go into effect beginning January 1, 2017.
When developing their alternative approaches to health care coverage, states must address certain requirements; specifically, that coverage:
- Be at least as comprehensive and affordable as coverage provided without a waiver
- Be held by a comparable number of the state’s residents as coverage provided without a waiver
- Not increase the federal deficit
As the United States moves closer to the next presidential election, the health care landscape will continue to shift and evolve. Beginning in 2017, an administration other than the Obama Administration will have stewardship over the ACA and its various provisions, including Section 1332 State Innovation Waivers, for the first time. States should be aware that—depending on where they are in the application process at the start of 2017—approvals may depend on the goals of the new administration.