Federal authorities are now reviewing an application from Gov. David Ige’s administration to grant Hawaii a waiver from provisions of the Affordable Care Act.
It may be March 2017 before the state learns whether the waiver, under review by the Department of Health and Human Services and the Treasury Department, is approved.
This “innovation waiver” is also called the “Section 1332 waiver.” It’s a reference to the part of the law spelling out the requirements for a web-based small business insurance exchange known as SHOP.
The state also argues that the federal SHOP site does not work as a substitute for the state exchange. That’s because it doesn’t hold employers to their requirements under the state law, the Prepaid Health Care Act.
Bottom line: All the other provisions of the ACA — the requirements that children be covered on parents’ plans up to age 26, that nobody be turned away for pre-existing conditions, and all the rest — are still in place.
The state basically returns to Prepaid to deliver employer-based coverage.
SOME bullet points of the waiver application:
>> “Hawaii’s experience with its state-based SHOP exchange demonstrated that it would be expensive, sparsely used, and increase costs while adding little value.”
>> “Hawaii does not propose any changes to the marketplace for individuals.” Individual customers here could still use the federal marketplace (healthcare.gov) “to access all options and subsidies to which they are entitled, or may purchase coverage directly.”
>> “Hawaii would waive the obligation to offer silver-level plans to small businesses since such plans do not conform to current Prepaid requirements. … Health insurers would retain the ability to offer silver-level plans in the rare event that employers seek them for Prepaid-exempt employees, but the offering would be optional.”
>> “Hawaii would also waive the requirement to accept multi-state plans, which are unlikely to comport with Prepaid and would be difficult to regulate.”
