The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
2017 Innovation Waivers: The Future is Right Around the Corner Webinar
Deborah Bachrach, Michael Kolber, and Joel Ario, Manatt Health Solutions
Section 1332 of the Affordable Care Act permits states to request innovation waivers from the Departments of Health and Human Services (HHS) and Treasury of certain ACA requirements, with waivers first effective in 2017. This waiver process has attracted some attention from thought leaders, but the states, the requesting parties on any waiver applications, have been focused on more pressing ACA implementation issues. That is changing as states begin to consider their longer term goals for health reform and specifically the opportunities afforded by section 1332 waivers.
In order to help states jump start their thinking about 1332 waivers, experts from Manatt Health Solutions presented the regulatory framework for those waivers and offered some examples that illustrate the broad range of potential waivers and the guardrails that ensure waivers continue to meet the goals of the ACA. This webinar addressed which ACA provisions are waivable, including the individual mandate, the employer mandate, essential health benefits, and exchange standards; how the coverage and fiscal guardrails might be applied by HHS and Treasury, which have yet to provide much guidance beyond a regulation that defines the waiver application process; and how 1332 waivers might be combined with Medicaid 1115 waivers to better achieve state goals across programs. The webinar slides can be found at the “download” button and a webinar recording can be found here.