Inside Health Policy asked a few health policy consultants and strategists whether Democrats may be missing an opportunity to highlight the success of their own 1332 waiver policy when it comes to the state reinsurance programs.
“It is an interesting scenario, not too afield of the situation on drug pricing, where Trump has adopted what would historically be seen as Democrat-driven championing of the issue,” says Billy Wynne of Wynne Health Group. “While I think it makes some sense for federally-focused Democrats to remain more reticent, given all of the nefarious things the Trump Administration is simultaneously doing with 1332 (and 1115) waivers to actually reduce coverage and increase consumer costs, I don’t think there should be room for doubt that Democrats support states taking steps to strengthen their Exchange markets.”
The party could be doing more to think broadly about waivers and how they could be used to expand coverage and bring down costs, Wynne adds.
“With relative stasis legislatively regarding ACA improvement, waivers really are the primary vehicle for the federal government to shape this state-driven phase of health reform,” he notes.
Wynne recently wrote a three-part series for Health Affairs that lays out ways that states could use the 1332 waivers and the Center for Medicare and Medicaid Innovation to establish a Medicare-based public option.
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