Insights

CMS Releases Checklist for Section 1332 Innovation Waivers


On May 16, 2017, CMS released a new checklist to help states pursue an innovation waiver under Section 1332 of the ACA. Specifically, this new checklist is intended to help states complete the required elements of the application that could allow them to set up high-risk pools for sicker residents and establish state-operated reinsurance programs.

As background, the ACA allows states to apply for an “innovation waiver” from the employer mandate penalty tax and certain other requirements for plan years beginning on or after Jan. 1, 2017. The waivers give states the flexibility to pursue their own strategies to provide their residents with access to health insurance that is affordable and provides MEC.

Through the release of this checklist, CMS is continuing to highlight innovation waivers as a way for states to modify existing laws or create something entirely new to meet the unique needs of their communities. CMS is promoting these waivers to give states the opportunity to develop strategies that best suit their individual needs, such as lower premiums for consumers, improved market stability and increased consumer choice.

If a state’s waiver proposal is approved, the state may be able to receive pass-through funding to help offset a portion of the costs for the high-risk pool/state-operated reinsurance and other premium stabilization programs while also lowering costs for consumers. According to the press release, CMS welcomes the opportunity to work with states on Section 1332 innovation waivers, and, in particular, invites states to pursue approval of waiver proposals that include high-risk pool/state-operated reinsurance programs.

Innovation Waiver Checklist »
Press Release »
Innovation Waiver Resources »