Reinsurance Waiver

Virginia’s ACA Section 1332 State Innovation Waiver

During 2021, the Virginia General Assembly passed HB 2332, the Commonwealth Health Reinsurance Program, which was signed into law on March 31, 2021 as Chapter 480, of the 2021 Virginia Acts of Assembly. This bill requires the State Corporation Commission to submit a waiver request for federal approval to establish a reinsurance program beginning January 1, 2023.

Section 1332 of the Affordable Care Act permits a state to apply for a State Innovation Waiver (also referred to as a section 1332 waiver) to pursue innovative strategies for providing residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA. The program also provides pass-through funding to the state for federal savings from approved initiatives.

The proposed reinsurance program would be funded through state general funds and federal pass-through funding provided under the waiver. It would reimburse carriers in the individual health insurance market for a proportion of the claims of covered individuals with high annual costs. The program is designed to increase affordability in the individual market with a statutory goal of decreasing premiums by up to 20 percent.

We have drafted a waiver application to secure federal authorization and pass-through funding to support the establishment of a reinsurance program in Virginia. The draft waiver application is available for public review.

Review SCC Case number INS-2021-00110 for additional information. Questions about the waiver can be sent to

The state public comment period on Virginia’s Section 1332 Draft Waiver Application ended on November 1, 2021. Information regarding the comment period, including copies of submitted comments, can be found in the documents section for Case No. INS-2021-00110

The State Corporation Commission held two virtual public hearings on Virginia’s Section 1332 Draft Waiver Application on Thursday, October 14, 2021 at 10:00 am and 7:00 pm. At these hearings, the Bureau of Insurance provided an overview of the reinsurance program. Members of the public were given the opportunity to comment on the contents of the waiver application during this hearing. While these hearings have concluded, written comments can be submitted through November 1, 2021.

Due to the ongoing COVID-19 public health emergency, we requested and received federal approval to conduct these hearings virtually.