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Member Research & Reports

Member Research & Reports

Washington: ACA Waiver Offers “Broad Leeway” to Develop Alternative Frameworks for Health Insurance

A federal waiver under the Affordable Care Act, known as section 1332, will offer several opportunities to improve quality and extent of health insurance coverage in Washington state when the waiver becomes effective in 2017, according to a report from the University of Washington School of Public Health.

The researchers — a group of graduate students led by two instructors — found it gives “broad leeway to waive key provisions of the ACA and develop alternative frameworks for providing health insurance.”

The number of people without health insurance In Washington state has dropped from 14.5 percent in 2012 to 7.3 percent in 2015. Though the effects of the ACA are evident, about 500,000 people in the state still face barriers to gaining coverage, according to researchers.

The researchers conducted a series of in-depth interviews with local, state and national informants. Among them were experts in insurance, law, policy and advocacy. The report outlines opportunities and challenges to improving the accessibility and affordability of health care by implementing the 1332 waiver. The report also presents other states’ strategies for expanding coverage.

The researchers suggest targeted fixes for certain excluded and vulnerable populations, such as undocumented immigrants. The state can provide a non-qualified health plan through the exchange or state subsidies to family members who cannot afford insurance, the report notes.

The state can also use the waiver to introduce more sweeping reforms, the researchers conclude, such as establishing a state-run basic health program to provide more affordable coverage to those severely below the federal poverty level.

The research was led by Mr. Aaron Katz, principal lecturer of health services, and Ms. Samantha Hatzenbeler, clinical instructor of health services.