- The waiver will provide coverage to at least a comparable number of the state’s residents as would be provided without the waiver;
- The waiver will provide coverage and cost-sharing protections that are at least as affordable as would be provided without the waiver;
- The waiver will provide for coverage that is at least as comprehensive as would be provided without the waiver; and
- The waiver will not increase the federal deficit.
In distributing the checklist, the agencies reiterated their interest in working with states on waivers aimed at lowering premiums, improving market stability, and increasing consumer choice and, once again, highlighted the opportunity to use the waiver to implement high-risk pools and state-operated reinsurance programs. In the introduction to the checklist they specify that, if a state shows a reduction in federal premium tax credit spending resulting from initiatives such as state-operated reinsurance programs, the state could receive pass-through funding for the program from those savings. This is a request that Alaska and Minnesota have made in their pending Section 1332 Waiver requests.
The checklist outlines what information states must submit to satisfy the required elements of a Section 1332 Waiver application, including relative to:
- Public notice and comment requirements;
- State legislative authority;
- Waiver requests;
- Quantitative analyses;
- Implementation timeline; and
- Reporting requirements.
- Authorizing legislation of such a program to be the subject of a Section 1332 waiver request must make the program contingent on the granting of the waiver; and
- The state must include a waiver request related to a request for pass-through funding to support such programs, such as a waiver to the single risk pool requirement.