Notes: Section 1332 of the ACA authorizes states to apply to waive specified provisions of the health law to facilitate state-specific programs for improving coverage. If a state's "innovation waiver" program is forecast to reduce federal spending, the state is entitled to have these savings passed through to it for purposes of implementing the program. The states identified in this table have secured, or are seeking, approval for innovation waivers that use these federal "pass-through" funds to partially finance the state's reinsurance program.
Program funding and projected premium effects data are estimates and come from the states' Section 1332 waiver applications.
For states with an approved waiver for which pass-through funding levels have been announced by the federal government, the federal share of program funding equals the federal pass-through funding for the year identified, as calculated by the federal government, divided by the total program funding, as estimated in the state's waiver application. For these states, the state share of funding equals the difference of total program funding and federal funding. For states with a pending waiver application, or with an approved application for which pass-through funding levels have not yet been announced, the respective funding shares are derived from information provided in the state's waiver application.
State reinsurance programs typically are designed following one of two broad models. A "condition-specific" reinsurance program covers some or all of an insurer's claims costs that have been incurred by enrollees diagnosed with one more specified high-cost health conditions. An "attachment point" reinsurance program covers some or all of an insurer's claims costs that exceed a specified threshold, or attachment point, regardless of the type of claim.