NPR, October 24, 2017
Alison Kodjak

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[...] On the same day that Iowa withdrew its waiver, CMS told Massachusetts that the agency couldn't approve the state's waiver in time for open enrollment, which begins Nov. 1. The Affordable Care Act requires all proposals to allow 90 days for public comment. CMS said Massachusetts' application came too late.

The failures of the two states' waiver applications follow a trend. Several states have seen their proposals delayed, denied or only partly approved, after administration officials actively encouraged states to apply.

Some critics say the denials are part of an administration effort to force the ACA marketplaces to fail. But Levitt says the agency is on solid legal ground in its strict interpretation of the rules.

Still , there appears to be a switch, given the administration's previous invitation to states to seek permission for insurance market changes. [...]

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