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Key Takeaway

As state policymakers look to control rising health insurance premiums and enhance affordable coverage options, many states have applied for and implemented Section 1332 waivers—also known as State Innovation Waivers or State Relief and Empowerment Waivers. Section 1332 of the Affordable Care Act (ACA) allows states to waive certain ACA requirements in order to customize their health insurance systems to better meet the state’s context and needs while retaining the basic protections of the ACA. States must seek federal approval for a Section 1332 waiver from the Centers for Medicare and Medicaid Services (CMS). The waivers were first made available in 2017.

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