Resource: State-Based Reinsurance Programs via 1332 State Innovation Waivers
Updated November 2023.
Section 1332 of the ACA authorizes states to waive key requirements under the law in order to experiment with policies in the individual and small-group insurance market within certain guardrails. This interactive map provides an overview of the different stages of states' 1332 waiver reinsurance applications. Click on any of the colored states for more in-depth details and a timeline of proposal development in each state.
Suggested Citation:
State Health Access Data Assistance Center (SHADAC). Resource: 1332 State Innovation Waivers for State-Based Reinsurance [Internet]. University of Minnesota, Minneapolis (MN) [cited ADD DATE]. Available from: https://www.shadac.org/publications/1332-state-innovation-waivers
Authors: Lynn A. Blewett, PhD, MPA, Natalie Schwehr Mac Arthur, PhD, MAc, and James Campbell
SHADAC researchers recently published an article in the Journal of Health Politics, Policy and Law on states’ development and use of state-based all-payer claims databases (APCDs).
Abstract
State policymakers are under increasing pressure to address the prohibitive cost of health care given the lack of action at the federal level. In 2020, the United States spent more on health care than any other country in the world—$4.1 trillion, representing 19.7% of the nation's gross domestic product. States are trying to better understand their role in health care spending and to think creatively about strategies for addressing health care cost growth. One way they are doing this is through the development and use of state-based all-payer claims databases (APCDs). APCDs are health data organizations that hold transactional information from public (Medicare and Medicaid) and private health insurers (commercial plans and some self-insured employers). APCDs transform this data into useful information on health care costs and trends. This article describes states' use of APCDs and recent efforts that have provided benefits and challenges for states interested in this unique opportunity to inform health policy. Although challenges exist, there is new funding for state APCD improvements in the No Surprises Act, and potential new federal interest will help states enhance their APCD capacity so they can better understand their markets, educate consumers, and create actionable market information.