The Center for Consumer Information & Insurance Oversight (CCIIO) has created a library of materials for states that are thinking of coming up with an alternative to the current Patient Protection and Affordable Care Act (PPACA) rules.
The PPACA Section 1332 State Innovation Waivers program lets states apply permission to change the way they structure their PPACA public exchange programs and their commercial health insurance rules.
See also: States gear up for the PPACA reboot year
A state would have to keep PPACA’s ban on use of personal health information other than location, age and tobacco use in underwriting, and it would require that any coverage created be at least as comprehensive as the coverage required under the standard PPACA rules.
A waiver program could not increase federal spending.
Section 1332 waiver coverage would have to offer consumers similar protection against high out-of-pocket costs.
But a state could change the individual mandate rules, the employer mandate rules, health plan benefits design requirements, and the system for allocating PPACA premium tax credit money.
Changes could take effect as early as 2017.
CCIIO — which is an arm of the Centers for Medicare & Medicaid Services (CMS), which is, in turn, an arm of the U.S. Department of Health and Human Services (HHS) — is the part of HHS directly in charge of HHS efforts to handle the commercial health insurance programs and market rules created by PPACA.
The new CCIIO waiver information page includes links to formal waiver program regulatory documents, informal waiver program fact sheets, and informal answers to frequently asked questions (FAQs) about the waiver program.
In a new fact sheet, for example, CCIIO officials say that a final regulation issued in February 2012 will shape what states have to put in their waiver applications. A state will have to provide a detailed 10-year budget plan showing that a waiver program would be “deficit neutral to the federal government,” officials say.
A state also has to provide a public comment period and allow for a meaningful level of public input, officials say.
HHS and the Treasury Department, the parent of the Internal Revenue Service (IRS), would share oversight over proposals, but a state could just send one application to HHS. HHS will take care of getting a copy over to the Treasury Department, officials say.
Federal officials intend to make final decisions about a waiver application within 180 days after they have decided that the application is complete, officials say.