Daschle on State Innovation and Federal Waivers

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Former Senate Majority Leader Tom Daschle talked to RealClearHealth about what the federal government can do to encourage state innovation in the implementation of the 2010 health law.

Earlier: Daschle: It's Time to Move Beyond 'Cut & Shift' for Medicare

Next: Daschle Urges a Focus on Value over Price

KARL EISENHOWER, RealClearHealth: Looking at the Affordable Care Act, you and former Speaker Newt Gingrich at the Bipartisan Policy Center have given some attention to Section 1332 waivers within the health law. A lot of people are familiar with the Section 1115 waivers that allow states to innovate in how they implement Medicaid. The 1332 waivers are something people haven't heard as much about. What are they and what do you recommend the states do with them?

TOM DASCHLE: Well 1332 is not as well known in part because it really hasn't gotten the attention in or out of government so far. The administration, as you know, just came up with the rules promulgating 1332 last December. And so it's just beginning now to get some traction and some understanding.

Basically what 1332 says is if the states can come up with a better way to do it that accommodates the same goals, that achieves the same results, they ought to be given the flexibility and the opportunity and even the encouragement to do that.

Only one state has attempted under 1332 to give some effort at this, and that's Vermont. But we think that there's some real opportunities here. What we suggested is that maybe the secretary could talk to the governors, maybe collectively, and say, look, what are the options? What are the possibilities that might exist with regard to moving this forward? How can we give you more flexibility to do the job as you would like to see it done?

Whether it's possible or not, no one really knows, but unless we try, unless we make that effort, nobody will ever know.

EISENHOWER: Do you feel that the administration has done enough to lay the groundwork so the states can take advantage of the waivers?

DASCHLE: I have to say I give [Health and Human Services] Secretary Burwell enormous credit for her can-do attitude and the amount of flexibility she has given the states. Over 32 states now have Medicaid waivers of various kinds. That number grows almost by the month. She has been very flexible, very innovative, very responsive. And I think she's going to show the same responsiveness as we look at this challenge, as well.

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