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CMS Releases Guidance on Section 1332 Waivers

The Centers for Medicare & Medicaid Services (CMS) released new guidance on Section 1332 waivers, which allow states to waive certain provisions of the Affordable Care Act as long as the changes are budget neutral and meet certain criteria ensuring access to comprehensive, affordable coverage.

The guidance aims to allow states increased flexibility under Section 1332 waivers, including by:

  • allowing states to provide consumers additional plan options;
  • expanding the definition of coverage to include additional types insurance, including short-term plans;
  • considering whether coverage is comprehensive and affordable for state residents as a whole, rather than focusing on specific populations;
  • increasing flexibility for states to leverage the federal exchange platform to implement new models; and
  • providing more flexibility for states to meet the state legislative authority requirement.

Eight states have Section 1332 waivers in place — Alaska, Hawaii, Maine, Maryland, Minnesota, New Jersey, Oregon, and Wisconsin. Several other states have withdrawn such waiver requests or CMS has deemed their requests incomplete.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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