1332 Reinsurance Waivers Revisited:  Could Oregon’s Approval Beget An Oklahoma Do-Over?

Just three weeks ago, CMS came under severe criticism for failing to act expeditiously on Oklahoma’s 1332 reinsurance waiver and only approving part of Minnesota’s waiver.  I was among the critics, suggesting that the agency’s action threatened the delicate bonds of trust between CMS and the states.  Channeling the Oklahoma letter withdrawing its pending waiver, I said the agency had some serious fence-mending to do if it wanted states to continue pursuing 1332 waivers. The agency has responded and I want to be among the first to commend CMS Administrator Seema Verma and her tireless staff for their prompt approval of Oregon’s waiver.  It took the agency nine months to approve Alaska’s pioneering reinsurance waiver, three months to partially approve Minnesota’s waiver, and just 40 days to approve Oregon’s proposal. This is precisely the streamlined process that the Alexander-Murray bipartisan bill envisions for relatively simple “look-alike” waivers.  (To be clear, this process should not apply to complex waivers that raise new issues meriting more extended review.) While the Oregon approval is important, I expect a residue of doubt will remain as states soak in the news.  Were the Oklahoma and Minnesota decisions the new norm and Oregon an aberration? Or does the Oregon decision represent a return to the consistent support that CMS had provided to states on reinsurance waivers? Most importantly, can states rely on the checklist published in May 2017? C...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Medicaid and CHIP 1332 waivers Source Type: blogs