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HHS Letter to States Encourages Section 1332 Waivers

The U.S. Department of Health and Human Services (HHS) is encouraging states to pursue Section 1332 State Innovation Waivers — in particular, proposals that include high-risk pool or state-operated reinsurance programs.

A March 13 letter to states signals the agency’s desire to work with states to pursue this type of waiver. HHS notes that it will work with states to provide assistance formulating a proposal that meets the requirements of the Section 1332 waiver.

Section 1332 waivers allow states to waive specific parts of the Affordable Care Act, such as provisions relating to qualified health plans, consumer choices, insurance competition, premium tax credits, and cost-sharing reductions in the health insurance marketplaces. To obtain approval, a state must provide access to quality health care that is at least as comprehensive and affordable as would be provided without the waiver. Further, waivers must provide coverage to a comparable number of residents as would be provided without the waiver, and proposals cannot increase the federal deficit.

Alaska is pursuing a Section 1332 waiver, the Alaska Reinsurance Program, for 2018 and beyond. HHS is reviewing Alaska’s proposal and cites it as an example in the letter.

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



About the Author

Zina Gontscharow is a former senior policy analyst for America's Essential Hospitals.

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