Section 1332 Waiver Discussion

[RayNY]

https://www.cms.gov/CCIIO/Programs-...s/Section_1332_state_Innovation_Waivers-.html

Buried in ACA is this obscure section I've never heard discussed.

The cliffnote is: Effective 1-1-17, states can institute single payer if they so choose, so long as they follow the guidance. ACA set the groundwork. High renewals, co-op failures, carriers pulling out, and the potential for millions of Americans to lose their insurance has created the motivation.

A half dozen states are at various points in the process of setting a plan up under this section.

Last Friday, 9/16/16, 33 senators (including all of the senate leadership) signed a non-binding resolution to add a public option to ACA.

Some reading from last week:

Senate Progressives, Activists Plan Big Public Option Push | Huffington Post

Would

Health care failures drive talk of public option - Washington Times


So, what's your understanding of all this?

 

[SamIam]

Yes a couple states Rhode Island and I believe Minnesota and a couple other are trying to set up a public option based on the section 1332 matter of fact Vermont tried doing a Single Payer based on the wavier until the realized they couldn't pay for it. Also Colorado is trying to get single payer based on this wavier. It also has to remain deficit neutral. If it was easy we would of had a bunch of commie states would of adopted it already.

 

[RayNY]

It also has to remain deficit neutral. If it was easy we would of had a bunch of commie states would of adopted it already.

"State Innovation Waivers are available beginning January 1, 2017. State Innovation Waivers are approved for five-year periods, and can be renewed. Waivers must not increase the Federal deficit."

FEDERAL deficit, not state. Can be a funding black hole as long as they don't touch federal dollars.

Not available until 1/1/17, I think that's the reason we haven't seen it yet.

9 states have already laws enacted related to 1332 waivers, 17 have filed bills. Hard or easy, it's being utilized.

 

[Gulfman]

Sounds like a setup for a system that is similar to Canada.

Socialized medicine for all...


.

 

[Yagents]

article on topic
A growing number of states are exploring public health plans | Washington Examiner

 

[Ann H]

The following article explains it well, that this waiver is not necessarily a bad thing. It allows states to take healthcare reform back from the Feds. They can eliminate EHBs, QHPs, metal tiers, etc. Their state can go without an exchange (either FFM or State based). They can even waive the IRS individual mandate, and employer mandate.

Then comes the handcuffs. They cannot eliminate pre-ex, GI, rating bands, and some of the mandates. And, they must make it as affordable (with subsidies and CSR) and as comprehensive as what now exists in the exchange products. By being budget neutral to the Feds, it means the states will still get as much money as the Feds would have spent on the exchange products (including subsidies, CSR, and exchange costs), but if it goes higher in costs the states absorb that.

So, these are tough hurdles.

Section 1332 Waivers: Breaking Out of the Obamacare Box | The Institute for HealthCare Consumerism