State innovation waivers may be back-door way for Republicans to dismantle the ACA

It's possible that Republican opponents of the Affordable Care Act could use a provision that will allow states to seek waivers to dismantle the healthcare reform law.

According to report from Politico, Republicans may not need a vote by Congress to repeal the ACA but they could use state innovation waivers, known as 1332 waivers, to allow states to replace key provisions of the law.

The state innovation waivers, which take effect in 2017, allow states to come up with alternatives to some of the ACA's core policies such as the individual mandate or premium tax credits for qualified health plans.

The provision allows the executive branch to waive pieces of the law for a state that chooses a different approach to expanding health coverage, according to Politico. It was designed to allow progressive states to go further than the health law.

But in the hands of a Republican president, the state waivers might be a tool to allow states to get rid of many ACA provisions, as he or she could allow Republican governors to nix the individual and employer mandates, individual exchanges or cost-sharing subsidies, according to Politico.

But it's not clear how far the waivers could go in changing the ACA. Under the law, a state may ask the administration to waive some of the requirements starting in 2017 in favor of an alternative that still achieves the health law's broad goals of maintaining affordable and quality healthcare coverage, Politico says. An alternative also cannot increase the federal deficit.

Conditions of the healthcare law could change with a Republican in the White House, Lanhee Chen, a senior policy adviser to Florida Sen. Marco Rubio's presidential campaign, told Politico. If states can craft their own healthcare plans, they could waive many of the law's requirements, he says.

To learn more:
- read the Politico report.