You can't make me do it, but i could be persuaded: A federalism perspective on the affordable care act

Journal of Health Politics, Policy and Law

Volumn 40, Issue 2, 2015, Pages 281-323

  Haeder, Simon F ^a   Weimer, David L ^a  

^a UNIVERSITY OF WISCONSIN MADISON   (United States)

Author keywords

Affordable care act (ACA); Health care reform; Health insurance marketplaces; Medicaid; Pre existing condition insurance plan (PCIP)

Indexed keywords

GOVERNMENT; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; INSURANCE; LEGISLATION AND JURISPRUDENCE; MEDICAID; ORGANIZATION AND MANAGEMENT; POLITICS; PUBLIC HEALTH; UNITED STATES;

ELIGIBILITY DETERMINATION; FEDERAL GOVERNMENT; HEALTH INSURANCE EXCHANGES; HUMANS; INSURANCE CARRIERS; INSURANCE, HEALTH; MEDICAID; NATIONAL HEALTH PROGRAMS; PATIENT PROTECTION AND AFFORDABLE CARE ACT; POLITICS; PREEXISTING CONDITION COVERAGE; STATE GOVERNMENT; UNITED STATES;

EID: 84929578840     PISSN: 03616878     EISSN: 15271927     Source Type: Journal    
DOI: 10.1215/03616878-2882219     Document Type: Article

References (120)

1. Adler, Jonathan H., and Michael F. Cannon. 2013. "Taxation without Representation: The Illegal IRS Rule to Expand Tax Credits under the PPACA." Health Matrix 23, no. 1: 119-95.
2. Alonso-Zaldivar, Ricardo, and Jennifer Agiesta. 2012. "AP-GfK Poll: Most Say Obama's Health Care Law Will Be Implemented; but Seven in Ten Expect Changes." Washington Post, September 26.
3. APWA (American Public Welfare Association). 1934. Medical Care for the Unemployed and Their Families under the Plan of the Federal Emergency Relief Administration. Chicago: APWA.
4. Atchinson, Brian K., and Daniel M. Fox. 1997. "The Politics of the Health Insurance Portability and Accountability Act." Health Affairs 16, no. 3: 146-50.
5. Baumrucker, Evelyne P., Cliff Binder, Elicia J. Herz, and Elayne J. Heisler. 2012. "Medicaid and the State Children's Health Insurance Program (CHIP) Provisions in ACA: Summary and Timeline."Washington, DC: Congressional Research Service.
6. Blalock, Hubert M., Jr. 1967. Toward a Theory of Minority-Group Relations. New York: Wiley.
7. Blewett, Lynn A., and Donna Spencer. 2008. "State High Risk Pools: An Overview." Minneapolis: State Health Access Data Assistance Center.
8. Blumberg, Linda J. 2011. "High-Risk Pools-Merely a Stopgap Reform." New England Journal of Medicine 364, no. 19: e39. doi: 10.1056/NEJMp1100112.
9. Bremner, Robert H., John Barnard, Tamara K. Hareven, and Robert M. Mennel, eds. 1971. Children and Youth in America: A Documentary History. Vol. 2, 1866-1932. Cambridge, MA: Harvard University Press.
10. Brown, E. Richard. 1981. Public Medicine in Crisis: Public Hospitals in California. Berkeley: Institute of Governmental Studies, University of California, Berkeley.
11. Brown, E. Richard. 1983. "Medicare and Medicaid: The Process, Value, and Limits of Health Care Reforms." Journal of Public Health Policy 4, no. 3: 335-66.
12. Bullock, Charles S., and Harrell R. Rodgers Jr. 1976. "Coercion to Compliance: Southern School Districts and School Desegregation Guidelines." Journal of Politics 38, no. 4: 987-1011.
13. Cauchi, Richard. 2012. "Coverage of Uninsurable Pre-existing Conditions: State and Federal High-Risk Pools." Denver: National Conference of State Legislatures.
14. CBO (Congressional Budget Office). 2010. Letter from Director Douglas W. Elmendorf to the Honorable Michael B. Enzi about the Provisions of the Patient Protection and Affordable Care Act regarding High-Risk Insurance Pools. June 21. cbo.gov/sites/default/files/cbofiles/ftpdocs/115xx/doc11572/06-21-high-risk_insurance:pools.pdf.
15. CCIIO (Center for Consumer Information and Insurance Oversight). 2013. "Covering People with Pre-existing Conditions: Report on the Implementation and Operation of the Pre-existing Condition Insurance Plan Program." Washington, DC: Centers forMedicare andMedicaid Services, US Department of Health and Human Services.
16. Chaikind, Hinda R., Jean Hearne, Bob Lyke, and Stephen Redhead. 2005. "The Health Insurance Portability and Accountability Act (HIPAA) of 1996: Overview and Guidance on Frequently Asked Questions." Washington, DC: Congressional Research Service.
17. Chepaitis, Joseph B. 1972. "Federal Social Welfare Progressivism in the 1920s." Social Service Review 46, no. 2: 213-29.
18. Chollet, Deborah. 2002. "Perspective: Expanding Individual Health Insurance Coverage: Are High-Risk Pools the Answer?"Web exclusive, Health Affairs, October, w349-w352. doi: 10.1377/hlthaff.w2.349.
19. Chollet, Deborah. 2010. "How Temporary Insurance for High-Risk Individuals May Play Out under Health Reform." Health Affairs 29, no. 6: 1164-67.
20. Clark, Jane Perry. 1938. The Rise of a New Federalism: Federal-State Cooperation in the United States. New York: Columbia University Press.
21. CMS (Centers for Medicare and Medicaid Services). n.d. "State by State Enrollment in the Pre-existing Condition Insurance Plan." www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/pcip-enrollment.html (accessed June 24, 2013).
22. Coughlin, Teresa A., and David Liska. 1997. "The Medicaid Disproportionate Share Hospital Payment Program: Background and Issues." Washington, DC: Urban Institute.
23. Coughlin, Teresa A., and David Liska. 1998. "Changing State and Federal Payment Policies for Medicaid Disproportionate-Share Hospitals." Health Affairs 17, no. 3: 118-36.
24. Council of State Governments. 1947. Grants-in-Aid and Other Federal Expenditures within the States. Rev. ed. Chicago: Council of State Governments.
25. Council of State Governments. 1949. Federal Grants-in-Aid: Report to the Committee on Federal Grants-in-Aid. Chicago: Council of State Governments, Committee on Federal Grants-in-Aid.
26. Cross-Call, Jesse, and Judith Solomon. 2011. "Rhode Island's Global Waiver Not a Model for How States Would Fare under a Medicaid Block Grant." Washington, DC: Center for Budget and Policy Priorities.
27. Dooren, Jennifer Corbett. 2014. "States Grapple with Fixing Problem-Plagued Health Exchanges." Wall Street Journal, April 3.
28. Dorn, Stan, and Todd Kutyla. 2004. Health Coverage Tax Credits under the Trade Act of 2002: A Preliminary Analysis of Program Operation. New York: Commonwealth Fund.
29. Eliot, Martha M., Jessie M. Bierman, and A. L. Van Horn. 1938. "Accomplishments in Maternal and Child Health and Crippled Children Services under the Social Security Act." Journal of Pediatrics 13, no. 5: 678-91.
30. Fellowes, Matthew C., and Gretchen Rowe. 2004. "Politics and the New American Welfare State." American Journal of Political Science 48, no. 2: 362-73.
31. Fernandez, Bernadette. 2011. "Health Insurance: State High Risk Pools." Washington, DC: Congressional Research Service.
32. Frist, Bill. 2012. "Why Both Parties Should Embrace Obamacare's State Exchanges." Week, July 18.
33. Fuchs, Beth C., Bob Lyke, Richard Price, and Madeleine Smith. 1998. "The Health Insurance Portability and Accountability Act (HIPAA) of 1996: Guidance on Frequently Asked Questions." Washington, DC: Congressional Research Service.
34. GAO (US Government Accountability Office). 2004. Health Coverage Tax Credit: Simplified and More Timely Enrollment Process Could Increase Participation. Washington, DC: GAO.
35. GAO (US Government Accountability Office). 2011. "Pre-existing Condition Insurance Plans: Program Features, Early Enrollment and Spending Trends, and Federal Oversight Activities." Washington, DC: GAO.
36. GAO(US Government Accountability Office). 2012. "Comparison of Implementation and Early Enrollment with the Children's Health Insurance Program."Washington, DC: GAO.
37. Garceau, Oliver. 1941. The Political Life of the American Medical Association. Cambridge, MA: Harvard University Press.
38. Giles, MichaelW., and Melanie A. Buckner. 1996. "Beyond Racial Threat: Failure of an Old Hypothesis in the New South: Comment." Journal of Politics 58, no. 4: 1171-80.
39. Grace, Martin F., and Robert W. Klein. 2009. The Future of Insurance Regulation in the United States. Washington, DC: Brookings Institution.
40. Grannemann, ThomasW., andMark V. Pauly. 2010. Medicaid Everyone Can Count On: Public Choices for Equity and Efficiency. Washington, DC: American Enterprise Institute.
41. Greenfield, Margaret. 1958. Medical Care for Welfare Recipients: Basic Problems. Berkeley: Bureau of Public Administration, University of California, Berkeley.
42. Haberkorn, Jennifer. 2010. "Party-Line Split on High-Risk Pools." Politico, May 3.
43. Haeder, Simon F. 2010. "Hollow State, Hollow Community? Healthcare Privatization in Fresno County, California." Master's thesis, California State University, Fresno.
44. Haeder, Simon F. 2012. "Beyond Path Dependence: Explaining Healthcare Reform and Its Consequences." Policy Studies Journal 40 (suppl. 1): 65-86.
45. Haeder, Simon F. 2013. "Making the Affordable Care ActWork: High-Risk Pools and Health Insurance Marketplaces." Forum 11, no. 3: 499-511.
46. Haeder, Simon F., and David L. Weimer. 2013. "You Can't Make Me Do It: State Implementation of Insurance Exchanges under the Affordable Care Act." Public Administration Review 73 (suppl. 1): S34-S47.
47. Haislmaier, Edmund F. 2006. "Massachusetts Health Reform: What the Doctor Ordered." Washington Post, May 4.
48. Hall, Jean P., and Janice M. Moore. 2012. Realizing Health Reform's Potential: The Affordable Care Act's Pre-existing Condition Insurance Plan: Enrollment, Costs, and Lessons for Reform. New York: Commonwealth Fund.
49. HealthCare.gov. n.d. "Pre-existing Condition Insurance Plan (PCIP)." US Department of Health and Human Services. www.healthcare.gov/glossary/pre-existing-condition-insurance-plan-PCIP/ (accessed June 24, 2013).
50. Hearne, Jean. 2005. "Medicaid Disproportionate Share Payments."Washington, DC: Congressional Research Service.
51. Henry J. Kaiser Family Foundation. 2013a. "Adult Income Eligibility Limits at Application as a Percent of the Federal Poverty Level (FBL), January 2013." kff.org/medicaid/state-indicator/income-eligibility-low-income-adults.
52. Henry J. Kaiser Family Foundation. 2013b. "Kaiser Health Tracking Poll, March 2013." Menlo Park, CA: Henry J. Kaiser Family Foundation.
53. Hero, Rodney E. 1998. Faces of Inequality: Social Diversity in American Politics. Oxford: Oxford University Press.
54. Hero, Rodney E., and Robert R. Preuhs. 2007. "Immigration and the Evolving AmericanWelfare State: Examining Policies in the U.S. States." American Journal of Political Science 51, no. 3: 498-517.
55. Herz, Elicia J. 2010. "Medicaid:APrimer."Washington, DC: Congressional Research Service.
56. Herz, Elicia J., Chris L. Peterson, and Evelyne P. Baumrucker. 2009. "State Children's Health Insurance Program (SCHIP): A Brief Overview." Washington, DC: Congressional Research Service.
57. Huen, William. 1999. California's Disproportionate Share Hospital Program: Background and Issues. Los Angeles: California HealthCare Foundation.
58. Huntington, Samuel P. 1981. American Politics: The Promise of Disharmony. Cambridge, MA: Belknap Press of Harvard University Press.
59. InsureKidsNow.gov. 2013. "Presumptive Eligibility for Medicaid and CHIP Coverage." US Department of Health and Human Services. www.insurekidsnow.gov/professionals/eligibility/presumptive.html.
60. Johnson, Annie. 2012. "Billions at Stake for Hospitals in Medicaid Expansion." Nashville Business Journal, September 14.
61. Joondeph, Bradley W. 2011. "Federalism and Health Care Reform: Understanding the States' Challenges to the Patient Protection and Affordable Care Act." Publius 41, no. 3: 447-70.
62. Kasperowicz, Pete. 2012. "Republicans Propose Giving States Power to Set Health Coverage for Pre-existing Conditions." Floor Action (blog), The Hill, August 3. thehill.com/blogs/floor-action/house/242077-republicans-propose-giving-states-power-to-set-health-coverage-for-pre-existing-conditions.
63. KCMU (Kaiser Commission on Medicaid and the Uninsured). 2012. "A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage." Washington, DC: KCMU.
64. Kenen, Joanne. 2012. "The Legal Hurdles Obamacare Still Must Clear." Politico, November 13.
65. Kramer, Lucy M. 1959. "Highlights of the Social Security Amendments of 1958." Public Health Reports 74, no. 1: 67-76.
66. Laudicina, Susan S. 1988. "State Health Risk Pools: Insuring the 'Uninsurable."' Health Affairs 7, no. 4: 97-104.
67. Lenroot, Katharine F. 1936. "Maternal and Child Welfare Provisions of the Social Security Act." Law and Contemporary Problems 3, no. 2: 253-62.
68. Lieberman, Robert C. 2002. "Ideas, Institutions and Political Order: Explaining Political Change." American Political Science Review 96, no. 4: 697-712.
69. Macdonald, Austin F. 1940. "Federal Aid to the States: 1940 Model." American Political Science Review 34, no. 3: 489-99.
70. Macmahon, Arthur W., John D. Millett, and Gladys Ogden. (1941) 1971. Administration of Federal Work Relief. New York: Da Capo.
71. Meckel, Richard A. 1990. Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850-1929. Baltimore: Johns Hopkins University Press.
72. Meier, Kenneth J. 1988. The Political Economy of Regulation: The Case of Insurance. Albany: State University of New York Press.
73. Meier, Kenneth J. 1991. "The Politics of Insurance Regulation." Journal of Risk and Insurance 58, no. 4: 700-713.
74. Merline, John. 2013. "Obamacare Exchange Subsidy Cost Hiked by $233 Billion." Investor's Business Daily, February 5.
75. Millman, Jason. 2013. "Gov. Rick Scott Embraces Medicaid Expansion in Florida." Politico, February 20.
76. Mitchell, Allison. 2012. "Medicaid Financing and Expenditures." Washington, DC: Congressional Research Service.
77. Mitchell, W. L. 1958. "Social Security and Public Health." Public Health Reports 73, no. 1: 34-38.
78. Moore, Judith D., and David G. Smith. 2005. "Legislating Medicaid: Considering Medicaid and Its Origins." Health Care Financing Review 27, no. 2: 45-52.
79. NAIC (National Association of Insurance Commissioners). n.d. "Fact Sheet-Temporary High Risk Pool Program." Kansas City, MO: NAIC.
80. Nather, David, and Carrie Budoff Brown. 2011. "Republicans Eye Costs, Not Uninsured." Politico, January 24.
81. Newsom, Mark. 2010. "Temporary Federal High Risk Health Insurance Pool Program." Washington, DC: Congressional Research Service.
82. Norman, Brett, and Jason Millman. 2012. "ACA Opponents Scramble for a Plan B." Politico, November 8.
83. Olson, Laura Katz. 2010. The Politics of Medicaid. New York: Columbia University Press.
84. OPM (US Office of Personnel Management). n.d. "Multi-State Plan Program and the Health Insurance Marketplace." www.opm.gov/healthcare-insurance/multi-state-plan-program (accessed June 26, 2014).
85. Pauly, Mark V. 2008. "Blending Better Ingredients for Health Reform." Health Affairs 27, no. 6: w482-w491.
86. Pear, Robert. 2010. "States Decide on Running New Pools for Insurance." New York Times, April 29.
87. Pecquet, Julian. 2010. "Abortion Coverage Restricted in High-Risk Insurance Pools." The Hill, July 29. thehill.com/policy/healthcare/111615-obama-administration-restricts-abortion-coverage-in-high-risk-pools.
88. Perkins, John A. 1958. "Grants-in-Aid Reappraised." Public Health Reports 73, no. 1: 27-30.
89. Peterson, Chris L. 2010. "Medicaid: The Federal Medical Assistance Percentage (FMAP)." Washington, DC: Congressional Research Service.
90. Peterson, Paul E. 1981. City Limits. Chicago: University of Chicago Press.
91. Peterson, Paul E., Barry G. Rabe, and Kenneth K. Wong. 1986. When Federalism Works. Washington, DC: Brookings Institution.
92. Pressman, Jeffrey L., and Aaron Wildavsky. 1973. Implementation: How Great Expectations in Washington Are Dashed in Oakland; or, Why It's Amazing That Federal Programs Work at All, This Being a Saga of the Economic Development Administration as Told by Two Sympathetic Observers Who Seek to Build Morals on a Foundation of Ruined Hopes. Berkeley: University of California Press.
93. Price, Carter C., and Christine Eibner. 2013. "For States That Opt Out of Medicaid Expansion: 3.6 Million Fewer Insured and $8.4 Billion Less in Federal Payments." Health Affairs 32, no. 6: 1030-36.
94. Reagan, Ronald. 1962. "Ronald Reagan Speaks Out against Socialized Medicine." Recording. Chicago: American Medical Association.
95. Sanner, Ann. 2013. "John Kasich Medicaid Expansion Bid Used Faith to Appeal to GOP." Huffington Post, February 22. www.huffingtonpost.com/2013/02/22/john-kasich-medicaid_n_2744153.html.
96. "SC Faith Groups Ask Lawmakers to Expand Medicaid." 2013. San Francisco Chronicle, April 23.
97. Schwartz, Tanya. 2010. "State High-Risk Pools: An Overview." Washington, DC: Kaiser Commission on Medicaid and the Uninsured.
98. Sommers, Ben, Rick Kronick, Kenneth Finegold, Rosa Po, Karyn Schwartz, and Sherry Glied. 2012. "Understanding Participation Rates in Medicaid: Implications for the Affordable Care Act." Washington, DC: Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
99. Soss, Joe, Sanford Schram, Thomas Vartanian, and Erin O'Brien. 2001. "Setting the Terms of Relief: Explaining State Policy Choices in the Devolution Revolution." American Journal of Political Science 45, no. 2: 378-95.
100. Sparer, Michael S. 2011. "Federalism and the Patient Protection and Affordable Care Act of 2010: The Founding Fathers Would Not Be Surprised." Journal of Health Politics, Policy and Law 36, no. 3: 461-68.
101. StateHealthFacts.org. 2012a. "Community Transformation Grants Awarded under the Affordable Care Act, as of FY 2012." Menlo Park, CA: Henry J. Kaiser Family Foundation. archive-org.com/page/1092484/2013-01-09/http://www.statehealthfacts .kff.org/comparemaptable.jsp?ind=998&cat=17 (accessed June 26, 2014).
102. StateHealthFacts.org. 2012b. "Consumer Assistance Program Grants under the Affordable Care Act, as of FY 2012." Menlo Park, CA: Henry J. Kaiser Family Foundation. http://kff.org/health-reform/state-indicator/consumer-assistance-program-grants/ (accessed June 26, 2014).
103. StateHealthFacts.org. 2012c. "Consumer Oriented and Operated Plan (CO-OP) Loans Awarded, 2012." Menlo Park, CA: Henry J. Kaiser Family Foundation. http://kff .org/health-reform/state-indicator/co-op-loans/ (accessed June 26, 2014).
104. StateHealthFacts.org. 2012d. "Nursing Workforce Development Grant Totals, as of FY 2012." Menlo Park, CA: Henry J. Kaiser Family Foundation. http://archive-org.com/page/1092484/2013-01-09/http://www.statehealthfacts.kff.org/compare maptable.jsp?ind=975&cat=17 (accessed June 26, 2014).
105. StateHealthFacts.org. 2012e. "Total Health Insurance Premium Review Grants Awarded, as of FY 2012." Menlo Park, CA: Henry J. Kaiser Family Foundation. archive-org.com/page/1092484/2013-01-09/http://www.statehealthfacts.kff.org/comparemaptable.jsp?ind=1000&cat=17 (accessed June 26, 2014).
106. State Reforum. 2013. "Tracking Medicaid Expansion Decisions." May 9. www.state reforum.org/medicaid-expansion-decisions.
107. State Reforum. 2014. "Tracking Medicaid Expansion Decisions: A Closer Look at Legislative Activity." February 7. www.statereforum.org/node/11675.
108. Stone, Julie, Evelyne P. Baumrucker, Cliff Binder, Elicia J. Herz, Elayne J. Heisler, Kelly Wilkicki, and Alexandra J. Rothenburger. 2010. "Medicaid and the State Children's Health Insurance Program (CHIP) Provisions in PPACA."Washington, DC: Congressional Research Service.
109. Stone-Axelrad, Julie, and Bob Lyke. 2005. "Health Coverage Tax Credit Authorized by the Trade Act." Washington, DC: Congressional Research Service.
110. Stuart, Harold C. 1936. "Progress of Public Health as It Relates to the Child." Journal of Pediatrics 8, no. 6: 758-72.
111. Thompson, Frank J. 1981. Health Policy and the Bureaucracy: Politics and Implementation. Cambridge, MA: MIT Press.
112. Thompson, Frank J. 2012. Medicaid Politics: Federalism, Policy Durability, and Health Reform. Washington, DC: Georgetown University Press.
113. Thompson, Frank J., and Courtney Burke. 2009. "Federalism by Waiver: Medicaid and the Transformation of Long-Term Care." Publius 39, no. 1: 22-46.
114. US Senate Subcommittee on Health of the Elderly. 1963. Medical Assistance for the Aged: The Kerr-Mills Program 1960-1963.Washington, DC: Government Printing Office.
115. Velsor-Friedrich, Barbara. 1996. "Health and Welfare Reform, Part 1: The Origins." Journal of Pediatric Nursing 11, no. 1: 62-63.
116. Vestal, Christine. 2011. "High-Risk Health Care Plans Fail to Draw Crowd." Stateline, September 6. www.stateline.org/live/details/story?contentId=597986.
117. Vestal, Christine. 2012. "In High-Risk Insurance, Enrollment Lags and Costs Soar." Stateline, March 9. www.pewstates.org/projects/stateline/headlines/in-high-risk-insurance-enrollment-lags-and-costs-soar-85899377386.
118. Vonderlehr, R. A. 1937. "Recent Extension of Venereal Disease ControlWork through the Provisions of the Social Security Act." Public Health Reports 52, no. 4: 95-103.
119. White, Audrey. 2013. "Interfaith Groups Rally for Medicaid Expansion." Texas Tribune, February 20.
120. Williams, J. Kerwin, and Edward A. Williams. 1940. "New Techniques in Federal Aid." American Political Science Review 34, no. 5: 947-54.