CMS issues new guidance for states applying for Section 1332 waivers

The Centers for Medicare & Medicaid Services and Department of the Treasury today issued revised guidance for states seeking a Section 1332 waiver of certain Affordable Care Act requirements. Under Section 1332 of the ACA, states can apply for a waiver of certain requirements but must demonstrate that the proposed waiver would provide access to quality health care that is at least as comprehensive and affordable as without the waiver.
 
According to CMS, the new guidance applies to waivers for plan years 2020 and later. The agency said the guidance focuses on the availability of comprehensive and affordable coverage, rather than the actual number of individuals estimated to receive such coverage, to allow states to provide access to coverage at different price points and benefit levels; and on the aggregate effects of a waiver rather than on specific sub-populations. CMS said the guidance also clarifies that existing state legislation, combined with a state regulation or executive order, may in some cases satisfy the requirement to enact a law implementing the waiver.
 
Among other changes, the guidance establishes five new principles for the waivers: providing increased access to affordable private market coverage; encouraging sustainable spending growth; fostering state innovation; supporting and empowering those in need; and promoting consumer-driven health care. CMS and Treasury will accept comments on the guidance for 60 days after its publication in the Oct. 24 Federal Register.