June 25, 2017


Want states to have health reform flexibility? The ACA already does that (Jason Levitis and Stuart M Butler, June 21, 2017, Brookings)

As Congress struggles to balance the goals of flexibility and adequate health coverage, it's worth noting that the Affordable Care Act (ACA) already includes a measure that does exactly that. Section 1332 of the ACA allows for "state innovation waivers" that provide broad flexibility for states to redesign their health insurance markets while ensuring that health coverage is not jeopardized.

Section 1332 was the bipartisan brainchild of Senator Ron Wyden (D-OR) and former Senator Bob Bennett (R-UT). The measure allows states to waive or modify many of the central coverage provisions of the ACA, redirecting the current federal subsidies flowing to the state toward implementing the state's own plan. To protect individuals, a waiver may be approved only if it won't leave more people uninsured or make coverage less affordable or comprehensive.  A waiver also cannot increase federal deficits.

Section 1332 has received praise from both ends of the ideological spectrum. Last year, former House Speaker Newt Gingrich and former Senate Majority Leader Tom Daschle wrote in the Washington Post that the waivers "can achieve what both sides earnestly wish for: providing more Americans with access to more affordable, flexible, patient-centered health care." The Trump administration has also been strongly supportive, encouraging states to apply and providing a detailed checklist to help states develop applications.

Posted by at June 25, 2017 7:35 PM