Issue Briefs | Apr 15, 2015

Innovation Waivers: An Opportunity for States to Pursue Their Own Brand of Health Reform

Deborah Bachrach, Joel Ario, and Hailey Davis, Manatt Health Solutions

States have long been the testing ground for new models of health care and coverage.  Section 1332 of the Affordable Care Act, which takes ef­fect in less than two years, throws open the door to innovation by authorizing states to rethink the law’s coverage designs. Under State Innovation Waivers, states can modify the rules regarding covered benefits, subsidies, insurance marketplaces, and individual and employer mandates. States may propose broad alternatives or targeted fixes, but all waivers must demonstrate that coverage will remain as accessible, comprehensive, and affordable as before the waiver and that the changes will not add to the federal deficit. This issue brief, prepared by Manatt Health Solutions and cosponsored by the Commonwealth Fund, describes how states may use State Innovation Waivers to reallocate subsidies, expand or streamline their marketplaces, replace or modify the mandates, and otherwise pursue their own brand of reform tailored to local market conditions and politi­cal preferences.


Expert Perspectives

October 4, 2023

How Medicaid Agencies Can Leverage Multi-Payer Aligned Measure Sets

This expert perspective reviews how Medicaid programs in Connecticut, Massachusetts and Rhode Island have engaged with commercial payers, providers, patients, advocates and other parties to create and adhere to multi-payer aligned measure sets. It describes the benefits to Medicaid agencies of participating in aligned measure set efforts, as well as tips and resources for Medicaid agencies intersted in measure alignment.

September 26, 2023

CMS Finalizes Medicaid Rule to Streamline Enrollment into Medicare Savings Programs

This expert perspective provides a high-level overview of key provisions included in the “Streamlining Medicaid; Medicare Savings Program Eligibility Determination and Enrollment” final rule that will facilitate enrollment and retention of Medicare Savings Program (MSP) coverage. MSPs are state-run programs that help low-income Medicare enrollees pay their Medicare premiums and/or cost-sharing. While the final rule’s effective date is November 17, 2023, CMS delayed compliance dates for most provisions until April 1, 2026, to reflect states’ competing priorities in light of the “unwinding” of the Medicaid continuous coverage requirement.