The U.S. Department of Health and Human Services (HHS) has given more information about the process states can use to ask for waivers from the standard Affordable Care Act coverage expansion rules.
HHS has submitted a draft of the proposed rules that would govern a state waiver application process to the Federal Register and plans to have the proposed rules appear in the Federal Register Monday.
The Affordable Care Act is the federal legislative package that includes the Patient Protection and Affordable Care Act (PPACA).
Republican governors in many states are reluctant to implement PPACA, and some have taken active steps to suspend implementation.
President Obama recently said the administration will try to accommodate requests from states that want to take a different approach to expand access to health coverage without increasing the federal budget deficit.
Obama gave increased use of health savings accounts as that type of innovation that
a PPACA state waiver program could allow.
Even without a waiver, a state can decide, for example, whether to let all willing, qualified insurers or just some insurers sell coverage through its PPACA health insurance exchange distribution system, officials say.
PPACA itself makes “State Innovation Waivers” available in 2017, and Obama administration officials say they are supporting the Empowering States to Innovate Act bill, a measure proposed by Sens. Ron Wyden, D-Ore., and Scott Brown, R-Mass.
To quality for a waiver, officials say, a state must provide a proposal that:
- Provides coverage that is at least comprehensive as the coverage that PPACA is supposed to provide through a new system of health insurance exchanges.
- Makes the coverage at least as affordable as exchange coverage.
- Will cover as many state residents as otherwise would be covered.
- Does not increase the federal budget deficit.