Recognizing that what works in Springfield, Oregon, may not always work as well in Springfield, Massachusetts, U.S. Senators Scott Brown (R- Mass.) and Ron Wyden (D-Ore.) introduced legislation that would give states the flexibility to implement their own health care plans when the bulk of the new law goes into effect in 2014. Under the current law, states won't be able to apply for waivers until 2017. The change would mean that states, with a history of innovating new approaches to health care -- like Massachusetts, Oregon and Vermont -- could continue those efforts, while other states would have an opportunity to start innovating their own approaches.
"States shouldn't be forced by the federal government to adopt a one-size-fits all health care plan. Each state's health care needs are different," Brown, said. "Our bill provides flexibility, and allows states like Massachusetts to opt out of portions of the health care law."
"I fought to include state waivers in the new health reform law because I have always believed that federal reform shouldn't constrain a state's ability to do better. Some of the most innovative approaches to health policy have originated at the local level, where lawmakers have a unique insight into their constituents' lives and the state waiver simply gives states the bandwidth to pursue those kinds of approaches," Wyden said. "That said, it doesn't make sense -- especially given the current budget environment -- to force states to put off or abandon health care innovations in order to fully implement the federal law. Bumping up the start date means that states can focus on ways to make the new health law work at its best from day one."
Wyden originally authored the "Waiver for State Innovation" as part of his bipartisan Healthy Americans Act, which he first introduced in 2006. He then attached the provision as an amendment to the Patient Protection and Affordable Care Act, which passed earlier this year. Under the provision, states can apply for a waiver from some of the requirements of the federal health reform law -- including the individual mandate, the employer penalty for not providing coverage, the exact standards for a basic health insurance policy and the structure of the health insurance exchange -- as long as states can demonstrate that they will cover at least as many citizens with coverage that is at least as comprehensive and affordable as prescribed under federal law. In other words, if states have a better way to cover their citizens than the federal government, the Secretary of Health and Human Services can give them the flexibility to put such a plan in place.
The current state waiver provision, however, doesn't allow states to start applying for waivers until 2017, which means that states, like Oregon and Massachusetts, may have to abandon many of their state based innovations to implement the federal law, while other states will be forced to spend money implementing the law for three years before they can work on improvements. In addition to moving up the start date, Wyden and Brown's legislation will allow states to apply for early approval so that their plans can go into effect in 2014.