News & Commentary

Some states find nuances in the letter of the ACA law

“That which does not kill us makes us stronger,” said Nietzsche. Goodness knows that the GOP and President Trump have been trying to kill the ACA, and/or replace it. There are battles on several fronts: legislative, judicial, political.

Meanwhile the law lives on, but whether it’s stronger is a matter of debate.

Eight states have been granted waivers on just what kind of coverage they may offer under the ACA. Such changes are allowed under Section 1332 of the law.

Section 1332 state innovation waivers

Source: Kaiser Family Foundation

The Kaiser Family Foundation reports that “the current statutory language requires that state waiver applications must demonstrate that the innovation plan will provide coverage that is at least as comprehensive in covered benefits; at least as affordable (taking into account premiums and excessive cost sharing); cover at least a comparable number of state residents; and not increase the federal deficit.”

The parts of the ACA the states may seek to waive include the individual and employer mandates; the essential health benefits; limits on cost sharing for covered benefits; metal tiers of coverage; insurance marketplace requirements, including the establishment of a website, a call center, and a navigator program; and premium tax credits and cost-sharing reductions. States cannot waive guaranteed issue, age rating, and provisions on health status and gender rating. The Trump administration allows states to make broader changes, if they so choose.

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