HR Management & Compliance

Departments Issue PPACA Regulations on Waivers for State Innovation

The U.S. Departments of Health and Human Services (HHS) and the Treasury recently issued proposed new regulations under the Patient Protection and Affordable Care Act (PPACA) that outline the steps states must take to acquire Waivers for State Innovation. Under the PPACA, in 2017, states will be able to ask for such waivers to allow them to come up with their own ways to improve health care and offer comparable coverage.

While addressing the National Governors Association, President Barack Obama recently endorsed legislation that would allow states to begin asking for Waivers for State Innovation in 2014 when important parts of the PPACA go into effect. The bill would allow states to opt out of certain controversial provisions such as the individual mandate and the employer coverage requirement as long as they could prove that their alternative meets the PPACA’s objectives.

The new proposed regulations specify that states will be eligible to receive such waivers as long as the states’ alternative health care system:

  1. provides coverage that is at least as comprehensive and affordable as coverage offered through the health insurance exchanges created by the PPACA;
  2. won’t increase the federal deficit; and
  3. covers at least as many state residents as the PPACA.

The proposed regulations also address what information waiver applications must contain, the periodic reports that states with waivers must submit, and post-award evaluations.

Comments on the proposed regulations are due on or before May 13, 2011.

Read the regulations

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