The Affordable Care Act in the States: Fragmented Politics, Unstable Policy.

Many argue that the frustrated implementation of the 2010 Affordable Care Act (ACA) stems from the unprecedented level of political polarization that has surrounded the legislation. This article draws attention to the law's "institutionalDNA" as a source of political struggle in the 50 states. As de...

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Publicado en:Journal of Health Politics, Policy & Law Vol. 45; no. 4; pp. 647 - 661
Autores principales: Béland, Daniel, Rocco, Philip, Waddan, Alex
Formato: Artículo
Publicado: Duke University Press Aug2020
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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          Béland, Daniel
          Rocco, Philip
          Waddan, Alex
        affil:
          McGill University
          Marquette University
          University of Leicester
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        United States
        Medicaid law
        Conflict (Psychology)
        Federal government
        Health services accessibility
        Health insurance
        Health policy
        Practical politics
        Socioeconomic factors
        Patient Protection & Affordable Care Act
        Health insurance exchanges
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          Health insurance
          Health policy
          Practical politics
          Socioeconomic factors
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          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)
          Administration of Public Health Programs
          Patient Protection & Affordable Care Act
          Health insurance exchanges
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        Affordable Care Act
        federalism
        health care reform
        Obamacare
        states
        Affordable Care Act
        federalism
        health care reform
        Obamacare
        states
      ab: Many argue that the frustrated implementation of the 2010 Affordable Care Act (ACA) stems from the unprecedented level of political polarization that has surrounded the legislation. This article draws attention to the law's "institutionalDNA" as a source of political struggle in the 50 states. As designed, in the context ofUSfederalism, the lawfractured authority in ways that has opened up the possibility of contestation and confusion. The successful implementation of the ACAvaries not only across state lines but also across the various components of the law. In particular, opponents of the ACA have experienced their greatest successes when they could take advantage of weak preexisting policy legacies, high levels of institutional fragmentation, and negative public sentiments. As argued in this article, the fragmented patterns of health care politics in the 50 states identified in previous research have largely persisted during the Trump administration. Moreover, while Republicans were unsuccessful at repealing the legislation, the administration has taken advantage of its structural deficiencies to further weaken the legislation's capacity to expand access to affordable, quality health insurance.
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      doctype: Article
      src: R
    language: English
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