SHADAC Director Lynn Blewett discusses Minnesota’s 1332 reinsurance waiver request and the federal response in a new post on the Health Affairs Blog.
The Highlights
Minnesota’s 1332 Waiver Request
Minnesota submitted a 1332 reinsurance waiver request to the Centers for Medicare and Medicaid Services in May 2017, asking for pass-through funding to support a reinsurance program and to support the state’s Basic Health Program, MinnesotaCare, which would otherwise face reduced funding with reinsurance in place.
Federal Response
CMS approved the pass-through funding for the state’s reinsurance program but not for the BHP, resulting in an estimated $369 million loss to the state over two years.
Current Status
CMS took longer to respond to Minnesota’s waiver request than is typical, and the state’s Republican legislature and Democratic Governor Mark Dayton found themselves without enough time to craft an alternative plan due to ongoing tensions between the two sides. In mid-October, Governor Dayton officially but only partially accepted the terms and conditions of the 1332 waiver, objecting to CMS's interpretation of federal law in reducing the state's BHP funding and noting that Minnesota “reserves all of its rights” to the funding. According to the Governor, MinnesotaCare is fully funded through 2019.
Dr. Blewett points out that Minnesota may have pursued a different strategy toward its coverage programs had the risk to BHP funding been known and calls for clear timelines and waiver guidelines from CMS moving forward.