Waivers can provide an opportunity for states to advance program objectives that are not otherwise permissible under federal law. Section 1115 of the Social Security Act (the Act) is the broadest waiver authority available for Medicaid and the State Children’s Health Insurance Program (CHIP). Section 1332 of the Patient Protection and Affordable Care Act is a new waiver authority that will allow states, beginning in 2017, to make changes to health insurance exchanges, qualified health plans, premium tax credits and cost-sharing subsidies, as well as the individual and employer mandates.
HHS and Treasury guidance in December 2015 provides some indication of the potential scope and limitations of Section 1332 waivers and their interaction with Medicaid and CHIP. This issue brief provides an overview of both types of waiver authority, including details on what can be waived, the application and approval process, and the waiver requirements.