Obamacare Waiver Gives States Opening For Huge Reforms. But Will They Take It?

Starting in 2017, the Affordable Care Act will allow states to use waivers to pursue virtually any type of proposals for health care reform that they can imagine. It’s a huge opportunity for states interested in expanding or changing how health care is delivered.

But will anyone actually take advantage of it?

California has discussed providing health coverage to its undocumented immigrants. Hawaii might want to reinstitute the more stringent employer mandate that the state had before Obamacare. Arkansas may use the waivers to continue and reshape its trendsetting “private option” for Medicaid expansion.

At least a half-dozen states have taken public steps toward seeking a 1332 waiver, according to a June report from Health Affairs.

The 1332 waiver is the ACA’s Swiss Army knife. States can ask for almost anything, including relief from many of the law’s major provisions, so long as it is determined by the Health and Human Services Department that they are still working toward the law’s goals of coverage and affordability. It is a huge, open-ended opportunity that has had health policy wonks nerding out since the law passed.