Coaxing Reluctant States to Take on Health Reform


By James C. Capretta
RealClearPolicy, Dec. 13, 2018

Last month, CMS released waiver concepts to give states examples of reforms they could pursue under section 1332 of the ACA. While states can’t alter the ACA’s protections for people with pre-existing conditions, allow insurers to deny coverage, or charge higher premiums to consumers with high expected health costs, they can:

  1. Use federal funding for the premium tax credits payable under the ACA to provide subsidies to individuals in a different manner
  2. Alter the essential health benefit requirements of the ACA
  3. Change other ACA insurance rules,
  4. Terminate the ACA exchanges while building (or contracting for) new mechanisms for establishing enrollment in health coverage.

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