1332 State Innovation Waivers
CFDA 93.423 · Federal Grants & Funding
Total Funding
$44.58B
Awards
19
Recipients
19
States
19
Last Updated
Mar 20, 2026
Yearly Funding Trend
| Fiscal Year | Obligations | Awards | YoY Change |
|---|---|---|---|
| 2024 | $44.58B | 19 |
Award Type Mix
| Type | Obligations | Awards |
|---|---|---|
| $0 | 0 |
Top 19 Awards under CFDA 93.423
Largest individual obligations for 1332 State Innovation Waivers.
| Award | Recipient | Awarding Agency | Place | FY | Obligation |
|---|---|---|---|---|---|
ASST_NON_SIWCM248002_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT | NYS DEPARTMENT OF HEALTH New York | Department of Health and Human Services Centers for Medicare and Medicaid Services | NY-90 | 2024 | $27,858,658,832 |
ASST_NON_SIWIW190006_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - COOPERATIVE AGREEMENT TO SUPPORT 1332 SIWS IN FEDERALLY FACILITATED EXCHANGES. | MARYLAND HEALTH BENEFIT EXCHANGE Maryland | Department of Health and Human Services Centers for Medicare and Medicaid Services | MD-90 | 2024 | $3,216,891,599 |
ASST_NON_SIWCM228001_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - THE GOALS OF THE REINSURANCE PROGRAM ARE TO STABILIZE THE MARKET BY REDUCING PREMIUMS AND TO ATTRACT/RETAIN… | DEPARTMENT OF INSURANCE OF THE STATE OF GEORGIA Georgia | Department of Health and Human Services Centers for Medicare and Medicaid Services | GA-90 | 2024 | $2,554,144,049 |
ASST_NON_SIWIW190007_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - STATE REINSURANCE PROGRAM DESIGNED TO REIMBURSE CARRIERS FOR CERTAIN HIGH COST CLAIMS IN THE INDIVIDUAL HEA… | BANKING AND INSURANCE, NEW JERSEY DEPARTMENT OF New Jersey | Department of Health and Human Services Centers for Medicare and Medicaid Services | NJ-90 | 2024 | $2,514,195,654 |
ASST_NON_SIWIW200011_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - THE COLORADO 1332 STATE INNOVATION WAIVER ALLOWS THE STATE TO DRAW DOWN FEDERAL FUNDS RESULTING FROM PREMIU… | COLORADO DEPARTMENT OF REGULATORY AGENCIES Colorado | Department of Health and Human Services Centers for Medicare and Medicaid Services | CO-90 | 2024 | $1,494,688,202 |
ASST_NON_SIWIW190008_075 COOPERATIVE AGREEMENT TO SUPPORT 1332 SIWS IN FEDERALLY-FACILITATED EXCHANGES - OCI DEVELOPED A 1332 STATE INNOVATION WAIVER APPLICATION TO ALLOW WISCONSIN TO LEVERAGE FEDERAL FUN… | STATE OF WISCONSIN COMMISSIONER OF INSURANCE Wisconsin | Department of Health and Human Services Centers for Medicare and Medicaid Services | WI-90 | 2024 | $1,313,151,970 |
ASST_NON_SIWCMS23001_075 COOPERATIVE AGREEMENT TO SUPPORT 1332 STATE INNOVATION WAIVERS UNDER SECTION 1332 IN FEDERALLY-FACILITATED EXCHANGES - VIRGINIA | STATE CORPORATION COMMISSION Virginia | Department of Health and Human Services Centers for Medicare and Medicaid Services | VA-90 | 2024 | $1,264,089,850 |
ASST_NON_SIWIW180002_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - NA | DEPARTMENT OF COMMERCE MINNESOTA Minnesota | Department of Health and Human Services Centers for Medicare and Medicaid Services | MN-90 | 2024 | $964,088,396 |
ASST_NON_SIWIW180004_075 COOPERATIVE AGREEMENT TO SUPPORT 1332 SIWS IN FEDERALLY-FACILITATED EXCHANGES - ALASKA STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT WAS APPROVED IN JULY 2… | AK DEPARTMENT OF COMMERCE COMMUNITY ECONO Alaska | Department of Health and Human Services Centers for Medicare and Medicaid Services | AK-00 | 2024 | $803,209,931 |
ASST_NON_SIWIW210015_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - THE REINSURAMCE PROGRAM | PENNSYLVANIA DEPARTMENT OF INSURANCE Pennsylvania | Department of Health and Human Services Centers for Medicare and Medicaid Services | PA-90 | 2024 | $646,396,707 |
ASST_NON_SIWIW180003_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - THE STATE OF OREGON (OREGON) IMPLEMENTED A STATE BASED REINSURANCE PROGRAM USING A FEDERAL PATIENT PROTECTI… | DEPARTMENT OF CONSUMER & BUSINESS SERVICES Oregon | Department of Health and Human Services Centers for Medicare and Medicaid Services | OR-90 | 2024 | $527,175,040 |
ASST_NON_SIWIW190009_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - THE WAIVER WE ARE REQUESTING WILL PROVIDE NEEDED PREMIUM RELIEF IN BOTH THE INDIVIDUAL AND THE SMALL EMPLOY… | MAINE GUARANTEED ACCESS REINSURANCE ASSOCIATION Maine | Department of Health and Human Services Centers for Medicare and Medicaid Services | ME-90 | 2024 | $324,263,614 |
ASST_NON_SIWCMS23002_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - THE WAIVER WE ARE REQUESTING WILL PROVIDE NEEDED PREMIUM RELIEF TO IDAHOANS IN THE INDIVIDUAL HEALTH INSURA… | IDAHO INDIVIDUAL HIGH RISK REINSURANCE POOL Idaho | Department of Health and Human Services Centers for Medicare and Medicaid Services | ID-90 | 2024 | $298,041,482 |
ASST_NON_SIWIW200012_075 COOPERATIVE AGREEMENT TO SUPPORT 1332 SIWS IN FEDERALLY-FACILITATED EXCHANGES - SEE ATTACHED DOCUMENT. | HEALTH AND SOCIAL SERVICES, DEPARTMENT OF Delaware | Department of Health and Human Services Centers for Medicare and Medicaid Services | DE-00 | 2024 | $256,376,775 |
ASST_NON_SIWIW200014_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - OPERATION OF STATE REINSURANCE PROGRAM PURSUANT TO TERMS OF SECTION 1332 WAIVER GRANTED BY CMS AND TREASURY… | STATE AUDITOR MONTANA Montana | Department of Health and Human Services Centers for Medicare and Medicaid Services | MT-90 | 2024 | $199,032,583 |
ASST_NON_SIWIW210017_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - GRANT FUNDS A TRADITIONAL STATE BASED REINSURANCE PROGRAM. | NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN BENEFIT ASSOCIATION New Hampshire | Department of Health and Human Services Centers for Medicare and Medicaid Services | NH-90 | 2024 | $152,257,596 |
ASST_NON_SIWIW200013_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT - ESTABLISHING AN INVISIBLE REINSURANCE POOL FOR THE INDIVIDUAL HEALTH INSURANCE MARKET. | INSURANCE NORTH DAKOTA DEPARTMENT OF North Dakota | Department of Health and Human Services Centers for Medicare and Medicaid Services | ND-00 | 2024 | $134,238,367 |
ASST_NON_SIWIW200010_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE AFFORDABLE CARE ACT | EXECUTIVE DEPARTMENT OF THE STATE OF RHODE ISLAND Rhode Island | Department of Health and Human Services Centers for Medicare and Medicaid Services | RI-90 | 2024 | $59,923,519 |
ASST_NON_SIWIW180001_075 STATE INNOVATION WAIVER UNDER SECTION 1332 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT | STATE OF HAWAII DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS Hawaii | Department of Health and Human Services Centers for Medicare and Medicaid Services | HI-90 | 2024 | $2,001,806 |
Top 19 awards shown, ranked by obligated amount. Dates reflect performance period; last-modified dates match USAspending.gov. Complete listings include all transaction history going back to FY2024.
Spending by State
| State | Funding | Awards |
|---|---|---|
| New York | $27.86B | 1 |
| Maryland | $3.22B | 1 |
| Georgia | $2.55B | 1 |
| New Jersey | $2.51B | 1 |
| Colorado | $1.49B | 1 |
| Wisconsin | $1.31B | 1 |
| Virginia | $1.26B | 1 |
| Minnesota | $964.1M | 1 |
| Alaska | $803.2M | 1 |
| Pennsylvania | $646.4M | 1 |
| Oregon | $527.2M | 1 |
| Maine | $324.3M | 1 |
| Idaho | $298.0M | 1 |
| Delaware | $256.4M | 1 |
| Montana | $199.0M | 1 |
| New Hampshire | $152.3M | 1 |
| North Dakota | $134.2M | 1 |
| Rhode Island | $59.9M | 1 |
| Hawaii | $2.0M | 1 |
Top Recipients
Agencies Administering This Program
Source: USAspending.gov · All Programs