Have the ACA's Exchanges Succeeded? It's Complicated.
The fight over health insurance exchanges epitomizes the rapid evolution of health reform politics in the decade since the passage of the Affordable Care Act (ACA). The ACA's drafters did not expect the exchanges to be contentious because they would expand private insurance coverage to low- and midd...
| Publicado en: | Journal of Health Politics, Policy & Law Vol. 45; no. 4; pp. 661 - 677 |
|---|---|
| Autores principales: | , , |
| Formato: | Artículo |
| Publicado: |
Duke University Press
Aug2020
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=144377075&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 144377075 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 03616878 HPP jtl: Journal of Health Politics, Policy & Law issn: 03616878 maglogo: N pubinfo: dt: Aug2020 vid: 45 iid: 4 pid: 154 pub: Duke University Press artinfo: ui: 144377075 10.1215/03616878-8255577 ppf: 661 ppct: 16 formats: tig: atl: Have the ACA's Exchanges Succeeded? It's Complicated. aug: au: Jones, David K. Gordon, Sarah H. Huberfeld, Nicole affil: Boston University su: Federal government Insurance Practical politics Public health Government regulation Health care reform Patient Protection & Affordable Care Act Health insurance exchanges sug: subj: Federal government Insurance Practical politics Public health Government regulation Third Party Administration of Insurance and Pension Funds All Other Insurance Related Activities Other Insurance Funds Health and Welfare Funds Health care reform Patient Protection & Affordable Care Act Health insurance exchanges keyword: Affordable Care Act federalism health insurance exchanges Affordable Care Act federalism health insurance exchanges ab: The fight over health insurance exchanges epitomizes the rapid evolution of health reform politics in the decade since the passage of the Affordable Care Act (ACA). The ACA's drafters did not expect the exchanges to be contentious because they would expand private insurance coverage to low- and middle-income individuals who were increasingly unable to obtain employer-sponsored health insurance. Instead, exchanges became one of the primary fronts in the war over Obamacare. Have the exchanges been successful? The answer is not straightforward and requires a historical perspective through a federalism lens. What the ACA has accomplished has depended largely on whether states were invested in or resistant to implementation, as well as individual decisions by state leaders working with federal officials. Our account demonstrates that the states that have engaged with theACAmost consistently appear to have experienced greater exchange-related success. But each aspect of states' engagement with or resistance to the ACA must be counted to fully paint this picture, with significant variation among states. This variation should give pause to those considering next steps in health reform, because state variation can mean innovation and improvement but also lack of coverage, disparities, and diminished access to care. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|