CAHC Claims Victory with CMS Guidance Expanding States' Flexibility Under 1332 Waivers

WASHINGTON, DC (October 22, 2018): The Council for Affordable Health Coverage (CAHC)  – a coalition of employers, insurers, life science companies, PBMs, brokers, agents, patient groups, and physician organizations – praised newly released guidance from the Centers for Medicare & Medicaid Services (CMS) expanding states' flexibility under the Affordable Care Act's Section 1332 state innovation waiver program. 

CAHC has long pressed policymakers for reforms to make 1332 waivers more user-friendly for states. Specifically, CAHC lobbied the administration for changes that allow states to submit a waiver request without first codifying their application as a state law and to ease the rigid guardrails used to accept or reject state proposals - both of which are reflected in CMS's guidance today.

CAHC President Joel White released the following statement: 

"CAHC is pleased that the administration has taken meaningful action to make 1332 waivers work for consumers and states, not against them," said CAHC President Joel White. "With much of Washington at a stalemate on health reform and the future of the Affordable Care Act, states are in a unique position to break the logjam and take action within their borders to improve affordability for consumers - they just need the freedom to do it."

White continued, "The 2015 guidance prevented choices and more affordable coverage options. Today's guidance reverses that while maintaining options for consumers who want to keep what they have. It speeds action by easing onerous requirements that states first codify their waiver application as state law - a costly and time-consuming proposition, especially in those states with biennial legislatures. The administration has rightly recognized that consumers facing soaring health costs needn't be forced to endure such a lengthy bureaucratic process in order to get relief. CMS is also taking a less stringent view of the guardrails used to accept or deny waiver applications, ensuring that state programs are evaluated on the basis of their ability to improve markets for consumers overall rather than their adherence to a rigid checklist of provisions that are designed to shut out states' good ideas. This guidance strikes a balance between upholding key protections in the ACA while giving states the freedom and the flexibility to care for the unique needs of their population as they see fit. CAHC thanks the administration for its diligent work and is proud to lend this policy our strong support."

CAHC Action on 1332 Waivers:

  • Responded to the administration's announcement on the drop in benchmark ACA premiums for 2019 with an October 12, 2018 statement encouraging further action - including 1332 waiver reform - to continue the downward cost trend.

  • Held a July 25, 2018 Congressional briefing entitled, "The State of 1332 Waivers." As Bloomberg Law reported, CAHC raised the possibility of forthcoming administration guidance to increase state flexibility under Section 1332. 

  • Made an appeal specifically to conservative lawmakers to support 1332 waiver reform as part of a market stabilization push in a January 2018 Daily Caller op-ed

  • Urged Congress to "provide states with real flexibility" under the 1332 waiver program in its 2017 "Holiday Wish List" delivered to Capitol Hill.

  • CAHC's Joel White penned a September 29, 2017 Washington Examiner op-ed entitled, "Untie States' Hands by Reforming Obamacare Waivers." 

  • Held a September 19, 2017 Congressional briefing entitled, "1332 Reasons for Reform: What States Are Doing to Strengthen Markets for Consumers" where the coalition urged policy changes to "spur state innovation."