State Politics and the Affordable Care Act: Choices and Decisions PDF
Preview State Politics and the Affordable Care Act: Choices and Decisions
State Politics and the Affordable Care Act A fter a great deal of discussion and debate across all levels of government, President Obama signed the Affordable Care Act (ACA) into law in March 2010. Since President Trump’s election into office, the ACA has stayed in the headlines. Trump has continued to call for the replacement and repeal of the ACA, and several efforts have spawned in both the House and the Senate to accomplish this goal. Unlike welfare reform, which was generally embraced by all states, the ACA has proved very divisive in some states, with some states actively seeking to block implementation. Alternative solutions continue to prove elusive. T o better understand the major factors driving decision-making process and state-level dynamics influencing state support or opposition of the ACA, this book examines the initial implementation through established support and opposition factors across four states: Alabama, Michigan, California, and New Hampshire. The choices made by states are a direct consequence of long-term forces and the choices made at the national level. State Politics and the Affordable Care Act will be of interest to scholars researching in public administration, policy formulation and implementation, and policy analysis. John C. Morris is Professor of Public Administration in the School of Public Service, and Professor of Political Science at Old Dominion University. He holds a PhD from Auburn University and has studied collaboration and public– private partnerships for more than 20 years. Dr. Morris has published widely in public administration and public policy. Martin K. Mayer received his PhD from the School of Public Service at Old Dominion University in the fall of 2016. Martin’s research interests include healthcare policy, local government innovation, and environmental policy. His work has been published in S ocial Science Quarterly , Politics and Policy , The Social Science Journal , and Politics and the Life Sciences . Robert C. Kenter holds an MPA from Troy University, Alabama, and a PhD from the School of Public Service, Old Dominion University, Norfolk Virginia. His research interest includes collaboration, privatization, and southern politics. His work has appeared in several journals and edited books. Luisa M. Lucero graduated with a PhD from the School of Public Service at Old Dominion University in 2017. Her dissertation focused on state-level health policy design, and she is currently working on additional research projects examining health policy. Routledge Research in Public Administration and Public Policy Community Development and Public Administration Theory Promoting Democratic Principles to Improve Communities Edited by Ashley E. Nickels and Jason D. 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Mayer, Robert C. Kenter and Luisa M. Lucero First published 2020 by Routledge 52 Vanderbilt Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2020 Taylor & Francis The right of John C. Morris, Martin K. Mayer, Robert C. Kenter and Luisa M. Lucero to be identified as authors of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice : Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested ISBN: 978-1-138-62409-2 (hbk) ISBN: 978-0-429-46103-3 (ebk) Typeset in Times New Roman by Apex CoVantage, LLC This book is dedicated to Molly, Addison, Elizabeth, Brady, and Sebastian—the next generation. Contents List of Tables viii List of Abbreviations ix Acknowledgments x 1 Why Do States Matter? Contemporary State Policy Choice 1 2 Getting to Obamacare: A History of Health Care Reform in the U.S. 13 3 The “Nuts and Bolts” of the ACA 30 4 A National Look at ACA Implementation Choices 42 5 Opposing the ACA: An Alabama Case Study 58 6 Dueling Sentiments: Michigan and the ACA 81 7 Live Free or Die: New Hampshire and the ACA 101 8 Taking the Lead: California’s Endeavor for Universal Health Care 117 9 The Broader Lessons of State Implementation of the ACA 136 References 151 About the Authors 170 Index 172 Tables 4.1 State Support 50 4.2 Testing Determinants of Support 55 4.3 Politics, Need, and Combined Models 56 Abbreviations ACA Affordable Care Act ADOI Alabama Department of Insurance BCBSAL Blue Cross/Blue Shield of Alabama CBO Congressional Budget Office CHIP Children’s Health Insurance Program CHRT Center for Healthcare Research and Transformation CMS Centers for Medicare and Medicaid Services FMAP Federal medical assistance percentages FPL Federal poverty level GDP Gross domestic product HHS U.S. Department of Health and Human Services MCPP Mackinac Center for Public Policy NFIB National Federation of Independent Business NHHP New Hampshire Health Plan NHID New Hampshire Insurance Department PPACA Patient Protection and Affordable Care Act SBM-FP State-based marketplace federal platform SCOTUS Supreme Court of the United States SPM State–Partnership Marketplace UAW United Automobile Workers
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