Health Insurance Flexibility and Accountability Demonstration Initiative (HIFA): A Policy Analysis Using Kingdon’s Policy Streams Model

Abstract

In August of 2001, the Department of Health and Human Services announced the Health Insurance Flexibility and Accountability (HIFA) Initiative. This initiative’s goal was to make the process through which states increase and expand access to health insurance for low-income individuals faster and more streamlined. However, the HIFA initiative was introduced at a time when the economy was stronger and the population at large (and the number of uninsured) had not yet been affected by the devastating aftermath of September 11, 2001. This article presents an overview of Section 1115 waivers and continues with a discussion of HIFA waivers. An analysis of HIFA waivers is provided using John Kingdon’s policy streams’ model. Last, the author comments on the current and future challenges confronting the HIFA initiative.