The Department of Health and Human Services (HHS) has published a proposed rule to implement the procedural framework for submission and review of State Innovation Waiver applications under section 1332 of the Affordable Care Act (ACA). Under the rule, states would have flexibility to apply for a State Innovation Waiver to pursue their own strategies to ensure their residents have access to high quality, affordable health insurance. The program is intended to allow states to implement policies that differ from those in the ACA if they provide coverage that is at least as comprehensive and affordable as the coverage offered through Health Insurance Exchanges, the state provide coverage to at least as many residents as otherwise would have been covered under the ACA, and the policies do not increase the federal deficit. Comments on the rule will be accepted until May 13, 2011. An HHS press release notes that while the ACA makes State Innovation Waivers available in 2017, President Obama supports bipartisan legislation that would make waivers available to states beginning in 2014.