Friday, March 11, 2011 Proposed Rules Promote State Flexibility in Providing Coverage New rules proposed yesterday outline the steps for states to receive waivers allowing them to pursue innovative strategies to ensure that residents have affordable access to the same level of health insurance required under the Patient Protection and Affordable Care Act (PPACA). State Innovation Waivers, which will be available in 2014, are designed to allow states to implement policies that differ from those in PPACA as long as they: Provide coverage that is at least as comprehensive as the coverage offered through health insurance exchanges. Make coverage at least as affordable as it would have been through the exchanges. Provide coverage to at least as many residents as otherwise would have been covered under PPACA. Do not increase the federal deficit. States could use a variety of strategies to innovate through a waiver, says the US Department of Health and Human Services, provided they meet the above requirements. For example, they could develop a new system for providing tax credits, which links small business tax credits to the tax credits for moderate-income families. Or they could change the benefit levels or add new benefit levels for health plans offered in the exchanges, providing consumers and employers even more choices. Read APTA's Issue in Focus brief on health exchanges at this link.