Nov, 16, 2021

More States Looking to Section 1332 Waivers

Heather Howard

As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems.  While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.

We have mapped out current state activity and included links to all the approvals, proposals, and even the authorizing legislation.  You’ll see that several states have approved waivers, but many more are actively considering them.  The list is geographically and politically diverse – the one constant being that states are interested in seizing opportunities to improve health care for their residents. If your state is interested in pursuing a Section 1332 waiver, SHVS has a 1332 waiver template, a checklist, and related issue brief detailing design and policy considerations for states. Additionally, see the latest Expert Perspective on the new federal waiver concepts for Section 1332 waivers.

States are also seeking opportunities to use the Medicaid program to strengthen coverage across the individual market and Medicaid. To track state activity around Medicaid buy-in programs, click here.

Waiver Approved

Alaska

  Approved Waiver   Application
Intent to Apply for Extension
  Legislation   Federal Funding Updates

Colorado (Reinsurance)

  Approved Waiver   Application   Legislation   Federal Funding Updates

Delaware

  Approved Waiver   Application   Legislation   Federal Funding Updates

Georgia

  Approved Waiver   Application   Legislation

Hawaii

  Approved Waiver   Application
Extension Approved
  Legislation   Federal Funding Updates

Maine

  Approved Waiver   Application
Intent to Apply for Extension
  Legislation   Federal Funding Updates

Maryland

  Approved Waiver   Application   Legislation, Legislation   Federal Funding Updates

Minnesota

  Approved Waiver
State Response
  Application   Legislation   Federal Funding Updates 

Montana

  Approved Waiver   Application   Legislation   Federal Funding Updates

New Hampshire

  Approved Waiver   Application   Legislation

New Jersey

  Approved Waiver   Application   Legislation   Federal Funding Updates
State Response

North Dakota

  Approved Waiver   Application   Legislation   Federal Funding Updates

Oregon

  Approved Waiver   Application   Legislation   Federal Funding Updates

Pennsylvania

  Approved Waiver   Application   Legislation  

Rhode Island

  Approved Waiver   Application   Legislation   Federal Funding Updates

Wisconsin

  Approved Waiver   Application
Attachment
  Legislation   Federal Funding Updates
State Response

Application Submitted

Colorado (Colorado Option)

  Draft Application   Deemed Complete   Extension Approved

Waiver Application Submitted, No Longer Pending

California

  Withdrawn   Application   Legislation

Idaho

  Deemed Incomplete Application   Legislation 

Iowa

  Deemed Complete,
Withdrawn
  Application,
Supplement
  No Legislation

Massachusetts

  Deemed Incomplete   Application   Legislation

Ohio

  Deemed Incomplete   Application   Legislation

Oklahoma

  Deemed Complete
Withdrawn
  Application   Legislation

Vermont

  Incomplete   Application   Legislation

Public Draft of Application

Louisiana

  Draft Application    Legislation Unsuccessful

Authorizing Legislation Enacted

Kentucky

  Legislation

Texas

  Legislation

Virginia

  Legislation

Nevada

  Legislation

Authorizing Legislation Passed, Vetoed