FISCAL WAIVERS AND STATE "INNOVATION" IN HEALTH CARE

This Article describes how the Department of Health and Human Services (HHS) has used fiscal waiver authorities--delegated power to alter federal payments to states under Medicaid and the Affordable Care Act (ACA)--to influence state health policy choices. It highlights how the agency uses its fisca...

Full description

Saved in:
Bibliographic Details
Published in:William and Mary law review 2021-04, Vol.62 (5), p.1477
Main Author: Lawrence, Matthew B
Format: Article
Language:English
Subjects:
Analysis
Delegation of powers
Federalism
Health care reform
Laws, regulations and rules
Medicaid
State budgets
Tax and expenditure limitations
Waiver (Civil procedure)
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:This Article describes how the Department of Health and Human Services (HHS) has used fiscal waiver authorities--delegated power to alter federal payments to states under Medicaid and the Affordable Care Act (ACA)--to influence state health policy choices. It highlights how the agency uses its fiscal waiver authorities to shape which reforms states choose to pursue, in some cases inspiring genuine state innovation and in others encouraging states to adopt reforms favored by HHS or discouraging states from adopting disfavored reforms. Moreover, while HHS has sometimes influenced state policy making in ways that further the substantive goals of the ACA and Medicaid (such as by facilitating reinsurance programs that make coverage more affordable), at other times it has done so in ways that undermine those goals (such as by incentivizing states to cut benefits and eligibility or by stifling state single-payer and public-option experiments).
ISSN:0043-5589