The Affordable Care Act (ACA) Section 1332 waiver option (or “state innovation waiver”) allows states to request approval for their alternative approach to the ACA related to the health insurance marketplace and employer and individual mandates, beginning January 1, 2017. This resource is important to health centers in states developing 1332 waivers since these waivers may impact the health center. Two examples of important changes a waiver could influence relate to Qualified Health Plans’ network inclusion of essential community providers and requirements on Prospective Payment System rates.