Hybrid Federalism, Partisan Politics, and Early Implementation of State Health Insurance Exchanges.

A central provision of the Affordable Care Act is establishment of state-level health exchanges. While states are given the opportunity to develop and administer these private insurance marketplaces, their plans must meet certain minimum standards or risk preemption by the federal government. This p...

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Publicado en:Publius: The Journal of Federalism Vol. 43; no. 3; pp. 368 - 392
Autores principales: Rigby, Elizabeth, Haselswerdt, Jake
Formato: Case Study
Publicado: Oxford University Press / USA Jul2013
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2013
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      pub: Oxford University Press / USA
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        atl: Hybrid Federalism, Partisan Politics, and Early Implementation of State Health Insurance Exchanges.
      aug:
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          Rigby, Elizabeth
          Haselswerdt, Jake
        affil:
          *George Washington University; erigby@gwu.edu
          George Washington University
      su:
        United States
        Intergovernmental cooperation
        Medical care
        Health insurance
        Government policy
        Insurance exchanges
        Federal government of the United States
        Patient Protection & Affordable Care Act
        U.S. states politics & government
        Twenty-first century
        U.S. states
      sug:
        subj:
          Intergovernmental cooperation
          Medical care
          Health insurance
          Government policy
          United States
          All Other Insurance Related Activities
          Direct individual life, health and medical insurance carriers
          Direct group life, health and medical insurance carriers
          Insurance exchanges
          Federal government of the United States
          Patient Protection & Affordable Care Act
          U.S. states politics & government
          Twenty-first century
          U.S. states
      ab: A central provision of the Affordable Care Act is establishment of state-level health exchanges. While states are given the opportunity to develop and administer these private insurance marketplaces, their plans must meet certain minimum standards or risk preemption by the federal government. This policy design establishes a hybrid model of intergovernmental policy making, which may serve to heighten conflict during implementation and further polarize states’ policies. Using new data on states’ efforts to establish exchanges and repeated-events duration modeling, we examine states’ early exchange implementation—identifying a key role for ideological and partisan considerations, as well as the implications of a federal policy design that puts conservative states in the difficult political position of choosing between resisting a law they oppose and preventing further federal intrusion.
      pubtype: Academic Journal
      doctype: Case Study
      src: R
    language: English
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