Empowering States to Innovate

Just last week, President Obama told the nation’s governors: “If your State can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does – without increasing the deficit – you can implement that plan, and we’ll work with you to do it.  I’ve said before, I don’t believe that either party holds a monopoly on good ideas.  And I will go to bat for whatever works, no matter who or where it comes from.”

If States can reform their health care systems earlier and better to meet the needs of their citizens, then they should have the flexibility to do so. Consistent with the proposed bipartisan “Empowering States to Innovate Act,” sponsored by Senators Ron Wyden, Scott Brown, Mary Landrieu, Ben Nelson, Joe Manchin, and Patrick Leahy, this Administration recognizes that each individual state is a powerful driving force behind their own health care.

Today, the Departments of Health and Human Services and the Treasury proposed rules outlining the steps States may pursue to move forward on their own strategies to ensure that all of their residents can obtain high quality, affordable health care. Specifically, the rules offered today suggest how a State can apply for an Innovation Waiver under the Affordable Care Act and, if approved, report on its progress.

State Innovation Waivers are designed to allow States to implement policies that differ from the new law so long as they:

• Provide coverage that is at least as comprehensive as the coverage offered under the Affordable Care Act.
• Make coverage at least as affordable as it would have been through the Affordable Care Act.
• Provide coverage to at least as many residents as the Affordable Care Act would have provided.
• Do not increase the Federal deficit.

The Innovation Waivers build on the flexibilities provided by the Affordable Care Act by giving States broader ability to innovate while also working to ensure that all Americans, no matter where they live, have access to affordable, quality health insurance. And these rules released today detail the content of the waiver application and how such proposals may be disclosed to the public, monitored, and evaluated.  We welcome suggestions on how this process can be improved.

As both a former State Insurance Commissioner and Governor, I understand the importance of State based leadership and tailored policy execution. That is why as implementation continues, we will keep an open dialogue between the Administration and Governors and States to make sure they have the flexibility and support they need as we work together to give Americans more freedom in their health care choices. 

Kathleen Sebelius is Secretary of Health and Human Services.