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The language around Section 1332 waivers in the market modernization proposed rule is similar to the Obama administration s 2015 guidance but features more explicit language about improving health equity. Biden s team wants states to apply for waivers that would increase the number of people covered, offer more comprehensive coverage, make comprehensive coverage more affordable or address health equity and the social determinants of health.
It s a significant departure from the Trump administration s exchange policies, which had primarily focused on making coverage more affordable by allowing consumers to buy skimpier plans. The Biden administration really wants to ensure that the plans people purchase have the coverage and cost-sharing protections that were originally intended under the ACA, said Ruth Liu, an expert on the ACA and commercial insurance at consultancy Avalere Health.
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