Starting in 2017, under the Affordable Care Act, state policymakers have an opportunity to apply for a State Innovation Waiver allowing small to radical health reforms that are designed for individual state’s context and preferences. Under the Section 1332 waiver, states can modify benefit and eligibility rules, subsidies, state insurance marketplaces, and employer and individual mandates. Coverage must remain as affordable, accessible, and comprehensive as before the waiver, and the plan must not increase the federal deficit. A new report by the Commonwealth Fund outlines the opportunities and application process.
Some states are already planning for these waivers. Arkansas is planning to harmonize their Medicaid, Medicaid expansion and exchange programs. Minnesota intends to use the waiver opportunity to integrate administration across programs. States could also use the waiver to implement their Basic Health Plan option under the Affordable Care Act. (Click here for a CSG/ERC webinar on the Basic Health Plan option for states.)