1332 -

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.

States utilize 1332 waivers to address specific local market challenges: Many states (e

A comparable number of residents must have coverage. Implementation Process Section 1332 waivers permit states to

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": Many states (e.g.

Colorado implemented a "Colorado Option" designed to improve coverage availability. Implementation Process

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)

New York received approval to expand its Essential Plan to residents up to 250% of the federal poverty level.