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1332 Waiver

Understanding Ohio's State Innovation Waiver


Ohio’s 2018-2019 operating budget (House Bill 49), required the Director of the Ohio Department of Insurance (ODI) to submit an application for a 1332 innovation waiver on behalf of the state of Ohio to the United States Department of Health and Human Services (HHS) and required the application to include waiving both the individual and the employer mandates.
Under the Affordable Care Act (ACA), most Americans are required to either have health insurance or pay a tax penalty. This is often called the “Individual Mandate” or “Individual Shared Responsibility Fee.”  In addition, most large employers are required to offer health insurance coverage to their employees or pay a fine which is known as the “employer mandate.”
Ohio's 1332 Waiver Request
After passage of the budget, the Department began working with actuarial firm Oliver Wyman to model different scenarios that could be submitted under 1332 waiver requirements while also following the requirements laid out in HB 49.  Before modeling could begin, however, Oliver Wyman gathered data from variety of sources to construct a baseline understanding of Ohio’s current health insurance market. 
Those results provide detail about how Ohio’s insured and uninsured population has changed in recent years.  Using the baseline information, Oliver Wyman has been working on different options the state could pursue as part of waiving the individual and employers mandates.  The direction of that work changed, however, at the end of 2017.
On December 22, 2017, Congress passed sweeping tax reform legislation that included changes to the individual mandate.  The legislation “zeroed out” the penalty that is associated with the individual mandate meaning there is no longer a fine for not having insurance.  However, it did not eliminate the mandate itself. 
Waiving the Individual Mandate
Because the federal tax reform legislation did not eliminate the actual requirement to have health insurance and because HB 49 requires ODI to purse a waiver eliminating this individual mandate requirement, ODI will be submitting an application to HHS requesting to waive the individual mandate in Ohio.  A copy of the draft application includes an actuarial analysis conducted by Oliver Wyman that projects the impacts of the waiver request on Ohio’s insurance market.  Specifically, because of changes included in the federal tax reform package passed in December, 2017 – there will be no negative impact to the individual market in Ohio as a result of this wavier application.   

Additional Resources 

The actual process of filing a waiver application as well as the information required in such a waiver request are established by the federal Centers for Medicare and Medicaid Services (CMS).  The guidance and regulations for that process are linked below. 

How to Comment on Ohio's Waiver Application

ODI is now seeking comment related to its 1332 waiver application to waive the individual mandate requirement in Ohio.  Consumers, interested parties and industry can provide feedback on the waiver.  Comments can be submitted to ODI for 30 days starting February 16 and ending March 18, 2018 by emailing 1332waiver@insurance.ohio.gov.
Additionally, comments can be mailed to:
The Ohio Department of Insurance
Director's Office
Attention: 1332 Waiver Application
50 West Town Street, 3rd Floor, Suite 300
Columbus, Ohio 43215
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The State of Ohio is an Equal Opportunity Employer

Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
John Kasich, Governor | Jillian Froment, Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | OSHIIP Hotline: 800-686-1578