Another positive trend, in Hempstead’s view, is that of giving the states more leeway with the ACA through an instrument called a Section 1332 waiver. She says these waivers “allow states to apply to make certain kinds of changes in their state market that might help to offset instability that’s unique to their own state…. Alaska did a 1332 waiver that allowed them to create some extra re-insurance in their market that was very helpful for them.” (There are some restrictions: Obamacare requires the states to provide coverage at least as comprehensive as that mandated by the ACA.) Hempstead notes the administration appears to have a “definite willingness” to encourage states to go this route.
“The only ones, in many states, that are hanging in there are the Blue plans…. If they start bailing out, I guess that’s the real canary in the coal mine.”–Mark Pauly