Center for American Progress

RELEASE: How States Can Use Section 1332 Waivers To Improve Health Care Affordability and Accessibility

RELEASE: How States Can Use Section 1332 Waivers To Improve Health Care Affordability and Accessibility

Washington, D.C. — One of the central goals of the Affordable Care Act (ACA) is innovation. To meet this goal, the ACA has provided states with Section 1332 waiver authority. A new Center for American Progress report overviews  the initial Section 1332 waivers that have funded state-based reinsurance programs and offers policy recommendations for future applicants and the US Centers for Medicare and Medicaid Services (CMS) to streamline the application process.

Section 1332 waivers enable states to seek approval from CMS and the U.S. Department of the Treasury to waive or modify certain provisions of the ACA to present an alternative approach to affordable, high-quality individual and small group health care coverage for their residents. This new report makes the case for two major policy recommendations that could expand affordable coverage: 

  1. Identify a primary affordability goal: State officials must first identify the primary affordability objective they hope to achieve via a waiver, in addition to which specific ACA requirements need to be waived in pursuit of that objective.
  2. Plan for a multistep, resource-intensive application process: Applying for a Section 1332 waiver requires enabling legislation, public hearings and comment periods, and actuarial and economic analysis. Refining and streamlining the application process would assist with the administrative challenges that state departments of insurance face.

“Section 1332 waivers are a chance for states to build off the successes of the ACA and pursue innovation that best supports their needs,” said Natasha Murphy, director of Health Policy at CAP and author of the report. “The federal government can better support state efforts by streamlining the application process and clarifying how waivers interact with other existing programs.”

Read the report: How States Can Use Section 1332 Waivers To Improve Health Care Affordability and Access” by Natasha Murphy

For more information or to speak with an expert, please contact Sarah Nadeau at snadeau@americanprogress.org.

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