Section 1332: State Innovation Waivers, Application Tools and Resources (July 15, 2019)
CMS has released resources to support states seeking Affordable Care Act (ACA) innovation waivers. As background, the ACA authorizes states to apply for waivers from certain of its provisions, including requirements regarding qualified health plans (QHPs), Exchanges, premium tax credits, and employer shared responsibility. To obtain a waiver, a state must provide coverage that is at least as comprehensive and affordable as would be provided absent the waiver, and the number of state residents with coverage must be comparable to the number of residents who would have coverage absent the waiver. Also, an innovation cannot increase the federal deficit. (See our Checkpoint article.) The HHS website has been updated with new resources designed to help states better understand and navigate the waiver application process, including a checklist of required waiver elements, and model templates aligned with previously released “waiver concepts.”
EBIA Comment: These resources underscore agency efforts to increase flexibility for states to obtain waivers from the ACA’s requirements. More can be expected−HHS recently released a Request for Information seeking ideas for how states might take advantage of agency guidance released in October 2018 to loosen the restrictions on waivers (see our Checkpoint article). For more information, see EBIA’s Health Care Reform manual at Section XXI.F (“Innovation Waivers”).
Contributing Editors: EBIA Staff.