1332

The proposal cannot increase the federal deficit. Key Strategic Uses & Examples

A comparable number of residents must have coverage.

Colorado implemented a "Colorado Option" designed to improve coverage availability. Implementation Process The proposal cannot increase the federal deficit

This report focuses on the program, a critical component of the Patient Protection and Affordable Care Act (ACA) that enables states to customize their health insurance markets. Executive Summary: Section 1332 Waivers

Coverage must be as robust as ACA marketplace plans. Implementation Process This report focuses on the program,

For a 1332 waiver to be approved by the Department of Health and Human Services (HHS) and the Department of the Treasury, the state’s proposal must meet four "guardrails":

Section 1332 waivers permit states to bypass specific ACA requirements—such as the individual mandate, employer mandate, or certain exchange standards—to implement innovative strategies that improve health insurance affordability, accessibility, and coverage. Approved states often use these waivers to establish or expand coverage to residents regardless of income (e.g., New York’s 2024 expansion ). Core Requirements (Guardrails) Approved states often use these waivers to establish

Many states (e.g., Alaska, Minnesota, Oregon ) use waivers to fund reinsurance, which compensates insurers for high-cost enrollees, successfully lowering premiums in the individual market.