On April 18, the Center on Budget and Policy Priorities released a brief examining health reform's state innovation waivers.  Health reform offers states five-year innovation waivers that exempt them from certain provisions of the law if they implement a system that covers as many individuals as health reform at no higher cost to the federal government.  The brief outlines what aspects of the law states can receive exemption from, how states can apply, and what criteria the U.S. Department of Health and Human Services (HHS) will use in determining whether to award states waivers.

From the report:

Section 1332 of the Affordable Care Act (ACA) allows states to request five-year waivers of certain key provisions of health reform, including the individual mandate and the requirement to set up an exchange.  To be approved, a “waiver for state innovation” must cover at least as many people as under the ACA and provide coverage that is at least as comprehensive and affordable, at no greater cost to the federal government. The Secretary of Health and Human Services and the Secretary of the Treasury have joint responsibility for approving waivers, which cannot take effect until January 1, 2017.

Full Report:  Understanding Health Reform’s Waivers for State Innovation (PDF | 109.57 KB) 

Center on Budget and Policy Priorities.  (2011).  Understanding health reform's waivers for state innovation.  Cross-Call, J.