Manuel Balce Ceneta / AP
The Trump administration today approved Alaska's proposal to expand a reinsurance program to cover high-cost patients — the first of what it says will be many state waivers from Affordable Care Act rules. Under the "Section 1332" waiver, Alaska will get extra federal funds to cover the costs of people with 33 expensive illnesses. The state told the Department of Health and Human Services it expects the program to reduce ACA premiums for everyone else by 20 percent.
Why it matters: HHS Secretary Tom Price has been encouraging other states to apply for the 1332 waivers, since it's one way the Trump administration can promote more state flexibility under the ACA even if Congress doesn't rewrite the law. Alaska is also using an approach the administration likes: directly subsidizing patients with expensive conditions so their costs don't raise premiums for healthy customers.