Most observers expect Mr. Becerra and the Biden administration to be amenable to waivers that expand health coverage in small and large ways.
Waivers are discretionary for the secretary, said Patricia Boozang, a senior managing director at the consulting firm Manatt Health. Theres a lot of innovative ideas that states have around expanding coverage and making it more affordable.
Illinois, for example, applied in November 2019 for a waiver to give mothers of newborns Medicaid coverage for one year after giving birth. The Trump administration has not acted on the request, but some observers expect it to get a fresh look and quicker approval after Mr. Becerra takes over the health agency.
States will also have the opportunity to pursue more experimental and larger coverage expansions. Many experts believe that Mr. Becerras waiver authority would easily allow a state-level public option to move forward. Nevada, Colorado and Connecticut have all considered the idea in recent years, and President-elect Biden supported the idea in his 2020 campaign.
I think a lot of states are dusting the cobwebs off some old plans and thinking about, how can we use these waivers, Ms. Boozang said.
An enterprising health secretary, working in partnership with a state, could also go even further. Some experts believe that a combination of Medicare, Medicaid and Affordable Care Act waivers could allow a state to build a single-payer plan with all of its federal health dollars.
Vermont had planned to do that in the early 2010s, and had identified waivers to create a state health plan to cover all Vermonters. The state held monthly meetings with the Obama administration to hammer out how to use federal waivers to set up its new health system.read more
Becerra Supports ‘Medicare for All,’ and Could Help States Get There
