State Innovation: The Key to Affordable Health Care Coverage Choices

Obamacare’s rigid and centralized federal regulation of the nongroup market is failing. Premiums have risen, choices have contracted, and enrollment in individual policies continues to fall. Section 1332 of the Obamacare statute provides states with very limited authority to escape Obamacare’s mandates and test new approaches to undoing some of this damage. Several states have successfully used a waiver to change market conditions sufficiently that premiums fell for individual health insurance while still protecting the ability of people with high health care costs to access care. Waivers alone, however, are not enough. Congress should enact legislation to empower states to establish consumer-centered approaches that reduce health care costs and increase choices. To make incremental progress towards this goal, the Trump Administration can simplify the unnecessarily restrictive waiver progress established by the Obama Administration in order to provide near-term relief to consumers without new federal spending.