Proposed Rule Outlines State Innovation Waiver Process

The Departments of Health and Human Services (HHS) and the Treasury proposed a new rule, March 10, outlining the steps states can take to receive a State Innovation Waiver under the Patient Protection and Affordable Care Act (Affordable Care Act).

The Affordable Care Act gives states the flexibility to receive a State Innovation Waiver beginning in 2017. President Obama has said he supports bipartisan legislation that would make waivers available to states beginning in 2014.

Upon receiving a State Innovation Waiver, states could implement policies that differ from those in the Affordable Care Act, so long as they:

  • Provide coverage that is at least as comprehensive as the coverage offered through Health Insurance Exchanges – new competitive, private health insurance marketplaces.
  • Make coverage at least as affordable as it would have been through the Exchanges.
  • Provide coverage to at least as many residents as otherwise would have been covered under the Affordable Care Act.
  • Do not increase the federal deficit.

For example, they could develop a new system for providing tax credits, which links small business tax credits to the tax credits for moderate-income families. Or they could change the benefit levels or add new benefit levels for health plans offered in the Exchanges.

The proposed rule describes the content of the waiver application and how such proposals may be disclosed to the public, monitored, and evaluated.

Read the proposed rule for complete details.

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