Spring promises of partnership on health care reform are growing cold for states

Rea S. Hederman Jr. Nov 02, 2017

This opinion piece appeared in The Hill. You can read the full piece by clicking the link below.

“In March, the Trump administration announced new plans for state flexibility on health care waivers for both Medicaid and state innovation 1332 waivers found in the Affordable Care Act. Recently, states have found this promised flexibility is not becoming a reality for either innovation or Medicaid waivers. If the Trump administration wants to fulfill the promise made earlier this year, then they need to send a strong signal to states that they indeed have a willing partner in Washington.

A letter, from then Health and Human Services Secretary, Tom Price to state governors, said the administration was “seeking to provide more flexibility and opportunities for innovation on the state level.” The letter outlined ways that states could use a Section 1332 waiver to lower premiums on the individual market through a high-risk pool. Later that spring, HHS published a checklist to help states prepare and file compliant 1332 waivers.

“As a result, states responded; and several state’s waiver applications included the creation of a high-risk pool. Other states, like Oklahoma and then Iowa, went even further seeking to utilize 1332s to escape some of the constraints of the Affordable Care Act. Twenty-four states have seriously explored using a 1332 waiver to improve their health care systems.

“The momentum for state flexibility grew as Alaska’s 1332 waiver was officially approved. Other states continued to file reinsurance waivers and hoped for an expedited review before open enrollment started.”

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