This report examines 1332 State Innovation Waivers as a solution to stabilize Montana’s individual health insurance market. The State Innovation Waiver, also known as the 1332 Waiver, was created as part of the Affordable Care Act and became an option for states to consider in 2017. States that want to use this option to explore ways to transform health care financing must apply to the U.S. Secretary of Health and Human Services and receive approval to implement a program that would waive certain requirements of the ACA. At least 24 states have or are considering legislation to authorize a 1332 waiver. Most of the waivers under consideration are seeking to reduce premiums and provide stability in the individual health insurance market. The report was commissioned by MHCF, completed by Christina Lechner Goe, J.D., and released in Nov 2018.