As states gear up to consider their new budgets, we should expect palpable anxiety about health care spending. States have spent more and more on health care over the years and will be called to do so again. That increased spending hasn’t automatically translated into better health and well-being, though. In fact, many policymakers express concerns that medical inflation crowds out investments in other areas like education, housing, and transportation that tend to prevent issues from escalating into health problems.

Mounting evidence shows progress toward turning the promise of better, more affordable health care into reality. Health reform efforts in recent years have been instrumental in reforming insurance practices, reducing the uninsured rate by a third, and – most exciting for those who work hand-in-glove with state partners – engaging stakeholders across industry and throughout government to forge new partnerships to deliver health care differently.

The State Network serves as a resource for states interested in Section 1332 waivers, also known as State Innovation Waivers, which are shaping up to be an important opportunity for states reaching toward the goal of expanded coverage. We’ll continue to provide analysis and other materials, updating this post as more becomes available.

Recently, the Government Accountability Office (GAO) released a letter that it sent to Sen. Orrin Hatch of Utah regarding Section 1332 Waivers, also known as State Innovation Waivers. These waivers, authorized under the Affordable Care Act (ACA), permit the federal Departments of Health and Human Services (HHS) and Treasury to waive certain aspects of the ACA upon a state’s request. The GAO was asked for information on the status of the waiver review and approval process, and talked to many stakeholders (federal and state officials and advocates) in preparing its response.

The third open enrollment period is coming to an end and the lack of drama may signal an opportune time for states to reassess the exchange model they are using. Certainly, eligibility determination and plan enrollment remain critical. But with many of the kinks and transitions worked out, states have an opportunity to pursue additional policy goals like improving customer service, increasing health plan competition, controlling administrative costs, and promoting delivery system transformation.

Today, the Department of Health and Human Services and the Department of Treasury released guidance on Section 1332 waivers, also known as State Innovation Waivers. The guidance focuses specifically on how the federal government will assess a proposal’s effect on the four guardrails, or general limits, on what the impact of a waiver would be on affordability, coverage levels, comprehensiveness of coverage and the federal deficit. The guidance also discusses the interaction of different programs, including Section 1115 waiver proposals on a Section 1332 application budget, and operational considerations for the federally-facilitated marketplace (FFM) and the Internal Revenue Service (IRS).

This Sunday, November 1, marks the start of the third annual Open Enrollment period for health coverage under the Affordable Care Act. Eligible Americans can shop for plans that will take effect on January 1, 2016. For most, this means the annual trip to healthcare.gov to review options and update personal information. What can be expected from this year’s open enrollment – the shortest period so far?

On Thursday, October 8, the State Health and Value Strategies program will host a webinar called Improving Care For Homeless Medicaid Beneficiaries: Emerging Best Practices And Recommendations For State Purchasers.

Last week, CMS published a new resource hub devoted to 1332 waivers containing links to regulations, FAQs, and fact sheets, as well as promise to issue more guidance “as additional questions and issues arise.” Also announced on the new page: the official email address for questions and completed applications is stateinnovationwaivers@cms.hhs.gov.

Thanks to today’s Supreme Court ruling, the Affordable Care Act and its promise to help Americans obtain affordable health coverage are here to stay. By a vote of 6-3, the majority held that Congressional intent was clear: qualified residents of all states, no matter what type of exchange they enroll in, are entitled to receive tax credits to help them afford health insurance.