The Departments of Health and Human Services (HHS) and Treasury have issued joint guidance on Affordable Care Act (ACA) “Section 1332” waivers, through which states can apply to implement alternative mechanisms to provide access to health care for their residents if certain conditions are met. Under the ACA, Section 1332 waivers can only be approved if a state’s proposal would provide coverage that is at least as comprehensive and affordable to a comparable number of state residents as would be provided absent the waiver, and if it would not increase the federal deficit. State Innovation Waivers are available effective beginning January 1, 2017. Regulations to implement the waivers were issued in 2012; the new guidance provides additional details regarding the standards for obtaining a waiver, the application procedure, the amount of funding that would be available to states, and certain other operational considerations. Comments may be submitted on the guidance at any time. The guidance will be published in the December 16, 2015 Federal Register.