Skip to Main Content
Don't have an account? Create Account
Don't have an account? Create Account

CMS Checklist Helps States Apply for Section 1332 Waivers

The Centers for Medicare & Medicaid Services (CMS) released a new checklist to help states complete applications for Section 1332 State Innovation Waivers.

Section 1332 waivers allow states to opt out of some Affordable Care Act (ACA) provisions and pursue alternative health insurance reforms. In particular, CMS encourages states to use the waivers to establish high-risk pools and state-operated reinsurance programs.

For CMS to approve a Section 1332 waiver, states must:

  • show that the waiver will provide access to quality health care that is at least as comprehensive and affordable as it would be without the waiver;
  • provide coverage to a comparable number of state residents as it would without the waiver; and
  • show that the waiver will not increase the federal deficit.

The new checklist tool helps states compile the necessary documents to apply for a waiver:

  • an application;
  • written evidence of compliance with public notice and comment requirements, including public hearings;
  • a description of the state’s enacted legislation providing for the waiver’s implementation; and
  • a list of ACA provisions the state wishes to waive and reasons for waiving those provisions.

This tool signals a growing desire on behalf of CMS to support Section 1332 waivers, as indicated in a March 2017 letter to states from Health and Human Services Secretary Tom Price.

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


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

Previous Next
Test Caption
Test Description goes like this