Implementing the Affordable Care Act Health Insurance Exchanges: State Government Choices and Policy Outcomes.

Intense partisan conflict characterized the Affordable Care Act's passage and continues to influence its implementation. The Act granted state officials significant discretionary authority over the implementation of health insurance exchanges and Medicaid expansion. Decisions by state officials vary...

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Bibliographic Details
Published in:Publius: The Journal of Federalism Vol. 46; no. 3; pp. 416 - 441
Main Authors: Shihyun Noh, Krane, Dale
Format: Article
Published: Oxford University Press / USA Summer2016
Subjects:
Online Access:View this record in EBSCOhost
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        atl: Implementing the Affordable Care Act Health Insurance Exchanges: State Government Choices and Policy Outcomes.
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          Shihyun Noh
          Krane, Dale
        affil: University of Nebraska, Omaha
      su:
        United States
        Health insurance
        Federal government
        Medicaid
        Government policy
        Patient Protection & Affordable Care Act
        Health insurance premiums
      sug:
        subj:
          Health insurance
          Federal government
          Medicaid
          Government policy
          United States
          Direct individual life, health and medical insurance carriers
          Direct group life, health and medical insurance carriers
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Patient Protection & Affordable Care Act
          Health insurance premiums
      ab: Intense partisan conflict characterized the Affordable Care Act's passage and continues to influence its implementation. The Act granted state officials significant discretionary authority over the implementation of health insurance exchanges and Medicaid expansion. Decisions by state officials vary from full state involvement to partial involvement to refusal to administer a state health exchange or expand Medicaid. The federal government administers a health exchange in those states choosing not to operate an exchange. The article examines whether variation in state program choices affects citizen decisions to enroll in an exchange. Also examined is whether health insurance premiums vary by which level of government administers the exchange. The analysis provides evidence that the Act's goals of increased enrollment in health insurance and affordable premiums are influenced by state government decisions on the extent of state involvement in health exchanges and Medicaid expansion.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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