Title

Federalism under the ACA: Implementation, Opposition, Entrenchment

Document Type

Book Chapter

Publication Date

2020

Editor(s)

Ezekiel J. Emanuel and Abbe R. Gluck

ISBN

9781541797772

Publisher

PublicAffairs

Language

en-US

Abstract

Whether to include the states as key implementers of the new national health care law was a fight from the beginning. In the end, the states were given a major role in ACA implementation--a role that generated not only resistance and policy inequality across states, as critics feared, but also some surprising collaboration and even resilience for the ACA's reforms. The law creates complex and shifting boundaries between state and federal control over health care policy and, in turn, reveals both the benefits and the drawbacks of health care federalism.

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