Tracking State Efforts to Stabilize and Reform Health Insurance Markets

NOTE: This alert (and the accompanying chart) were updated on October 4, 2017 to reflect the latest State Innovation Waiver developments.

As efforts to make sweeping legislative changes to the Affordable Care Act (ACA) at the federal level have stalled, states are increasingly looking to stabilize and reform their own health insurance markets. Section 1332 of the ACA authorizes states to waive certain ACA provisions and receive federal funding for state programs, provided such proposals meet four guardrails. Specifically, these guardrails are that the waiver must:

1. Provide coverage to at least as many people as would be provided without the waiver.
2. Provide coverage that is at least as comprehensive as would be provided without the waiver.
3. Provide coverage that is at least as affordable as would be provided without the waiver.
4. Not increase the federal deficit.

In the absence of federal legislation, Section 1332 may be the most important policy tool at a state’s disposal. To help health industry stakeholders keep tabs on these proposed waiver programs, we’ve put together a chart that briefly summarizes such State Innovation Waivers.

Updates will be made periodically as waivers make their way through the required state and federal review processes and additional states develop their own proposals.