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CMS Releases Section 1332 Waiver Resources

The Centers for Medicare & Medicaid Services (CMS) released resources to help states better understand state relief and empowerment waivers, also known as Section 1332 waivers. The resource tools include an updated checklist of required waiver elements and model templates.

Section 1332 waivers allow states to waive certain provisions of the Affordable Care Act as long as the changes are budget-neutral and meet certain criteria ensuring consumer access to comprehensive, affordable coverage. The resource tools further detail how to use each wavier concept to improve state insurance markets. The templates outline what states need to cover in their applications and identify areas of flexibility and variations states can consider. CMS also updated the checklist states can use when applying for a waiver. CMS released these resources to help states develop insurance markets that best meet residents’ needs.

CMS in October 2018 released guidance to increase flexibility for states seeking Section 1332 waivers by allowing additional plan options and types of coverage, among other changes. Following up in May, CMS put out a request for ideas for innovative programs and waiver concepts states could consider in developing these waivers.

Eight states have Section 1332 waivers in place: Alaska, Hawaii, Maine, Maryland, Minnesota, New Jersey, Oregon, and Wisconsin. To date, all approved Section 1332 waivers are for reinsurance programs. Several other states have withdrawn such waiver requests or CMS has deemed their requests incomplete.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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