Pascal's Wager: Health Insurance Exchanges, Obamacare, and the Republican Dilemma.
Enactment of the Patient Protection and Affordable Care Act (ACA) created a dilemma for Republican policy makers at the state level. States could maximize control over decision making and avoid federal intervention by establishing their own health insurance exchanges. Yet GOP leaders feared that cre...
| Publicado en: | Journal of Health Politics, Policy & Law Vol. 39; no. 1; pp. 97 - 138 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Duke University Press
Feb2014
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| 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=94464066&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 94464066 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: Feb2014 vid: 39 iid: 1 pid: 154 pub: Duke University Press artinfo: ui: 94464066 10.1215/03616878-2395190 ppf: 97 ppct: 41 formats: tig: atl: Pascal's Wager: Health Insurance Exchanges, Obamacare, and the Republican Dilemma. aug: au: Jones, David K. Bradley, Katharine W. V. Oberlander, Jonathan affil: University of Michigan University of North Carolina at Chapel Hill su: United States Practical politics State governments Health insurance Human services programs Endowments Patient Protection & Affordable Care Act sug: subj: Practical politics State governments Health insurance Human services programs United States Grantmaking Foundations Direct individual life, health and medical insurance carriers Direct group life, health and medical insurance carriers Endowments Patient Protection & Affordable Care Act ab: Enactment of the Patient Protection and Affordable Care Act (ACA) created a dilemma for Republican policy makers at the state level. States could maximize control over decision making and avoid federal intervention by establishing their own health insurance exchanges. Yet GOP leaders feared that creating exchanges would entrench a law they intensely opposed and undermine legal challenges to the ACA. Republicans' calculations were further complicated by uncertainty over the Supreme Court's ruling on the ACA's constitutionality and the outcome of the November 2012 elections. In the first year of operation, only seventeen states and the District of Columbia chose to design and implement their own exchanges; another six partnered with the federal government, and twenty-seven states ceded control to Washington. Out of thirty states with Republican governors in 2013, only four launched their own exchange. Why did many Republican-led states that initially appeared open to establishing exchanges ultimately reverse course? Drawing on interviews with state policy makers and secondary data, we trace the evolution of Republican responses to the exchange dilemma during 2010-13.We explore how exchanges became controversial and explain why so few Republican-led states opted for their own exchange, focusing on the intensifying resistance to Obamacare amid a rightward shift in state politics, partisan polarization, and uncertainty over the ACA's fate. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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