Health Advocate: Section 1332 Waivers for State Innovation and Medicaid

Executive Summary

In December 2015, CMS provided guidance on section 1332 waivers and clarified the interactions between section 1332 and Medicaid. In this month’s Health Advocate, we detail the “guardrails” for using section 1332 authority, the limits on combining 1332 and Medicaid waivers, and the potential impacts for Medicaid expansion. Ultimately, although section 1332 can waive many Marketplace rules, it is fundamentally a Marketplace authority and cannot waive Medicaid requirements or capture Medicaid funding. As states move forward with 1332 projects, it is essential to ensure projects comply with the guardrail protections and do not negatively impact Medicaid protections or funding.

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