Keeping innovation in health care

Rea S. Hederman Jr. Sep 26, 2019

This opinion piece appeared in The Hill.

Senate Democrats are trying to remove choice and flexibility from health care and state health insurance markets. This time they hope to force a vote under the Congressional Review Act to rollback Trump administration reforms that have allowed states to expand affordable health insurance options for their citizens.

The Affordable Care Act — as originally intended — permits state innovation or “section 1332” waivers so that states may propose alternative ways to offer health insurance. As their name suggests, innovation waivers allow states flexibility to innovate and think creatively in designing health insurance programs and protocols that will meet the needs of their constituents.

The waivers, of course, must be approved by the Department of Health and Human Services, and must satisfy federal requirements for affordability, deficit neutrality, and coverage, but they give states a way out of the one-size-fits-all approach otherwise imposed by the Affordable Care Act.

The Obama administration issued hyper-restrictive guidance interpreting the section 1332 waiver provisions and ignored bipartisan requests from governors across the country seeking more flexibility. The Obama-era guidance effectively shut down innovative alternatives and required states to offer only insurance rife with expensive federal mandates and burdens.

The crabbed view of innovation waivers taken by the Obama administration seemingly raised the price for health insurance and made it ultimately unaffordable for many of those that the ACA seemed intended to help.

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