In 2018,
2017 Wisconsin Act 138
was passed with bipartisan support in the state Legislature creating the Wisconsin Healthcare Stability Plan (WIHSP,) a state-based reinsurance plan. Later that year, OCI applied for a 1332 Waiver for State Innovation under the Affordable Care Act to leverage federal funding for WIHSP.
On July 29, 2018, the U.S. Department of Health and Human Services and the U.S. Department of the Treasury approved Wisconsin's 1332 Waiver application. The initial approval was effective January 1, 2019.