New Guidance on ACA State Waivers

The U.S. Department of Health and Human Services and U.S. Department of the Treasury recently released guidance (80 Fed. Reg. 78131, 12/16/15) for State Innovation Waivers under Section 1332 of the Affordable Care Act (Pub. L. No. 111-148, Title I, §1332, 124 Stat. 203, 3/23/10; 42 U.S.C. 18052).  Prominent in the list of waiver proposal requirements is “that the waiver would provide coverage to a comparable number of residents of the state as would be provided coverage absent the waiver, would provide coverage that is at least as comprehensive and affordable as would be provided absent the waiver, and would not increase the Federal deficit.”  If approved, the state may receive pass-through funding – “the amount of forgone Federal financial assistance that would have been provided to is residents pursuant to specified ACA programs.”  State Innovation Waivers are available for effective dates of 1 January 2017 and later, may be approved for up to five years, and can be renewed.  The recent guidance expands upon 2012 state waiver regulations (45 C.F.R. 155; 31 C.F.R. 33), and comments on the guidance may be submitted at any time.  For additional information, see the U.S. Center for Consumer Information & Insurance Oversight Section 1331: State Innovation Waivers page.