Beyond defeat or defiance
Redefining state-based health reform under Obamacare

This month, the post-election rollout of the Obama administration’s plans to implement insurance exchanges under the Affordable Care Act (ACA) in time for January 1, 2014 enrollment was met with substantial state government opposition, more questions than answers, and warning signs of a train wreck ahead. A clear majority of states (32) are not fully on board with running their own ACA-compliant exchanges. At least 20 of those states would rather leave the daunting implementation process entirely in the hands of federal officials.

This strong state resistance to enlisting as junior partners, or sorcerer’s apprentices, in building the key regulatory architecture for Obamacare’s plans to expand subsidized health insurance coverage surprised the law’s advocates. To some degree, it represents a continuation of bitter divisions over the still-unpopular health law. It’s also good short-term politics for Republican state officials looking to avoid the blame for its ongoing complications and contradictions.

But one way or another, taxpayer subsidies for new ACA coverage for at least several million Americans will start flowing out of Washington in 2014. The results of the 2012 election, as well as last June’s Supreme Court decision upholding the health law as constitutional, mean that Obamacare’s plans for even more doses of health care subsidies, regulations, and mandates cannot be fully stopped. However, changing the terms of how this happens and reshaping the future nature of our health system remain possible. 

Read the full article at American.com.

 

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Thomas P.
Miller

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Monday, July 21, 2014 | 9:15 a.m. – 11:30 a.m.
Closing the gaps in health outcomes: Alternative paths forward

Please join us for a broader exploration of targeted interventions that provide real promise for reducing health disparities, limiting or delaying the onset of chronic health conditions, and improving the performance of the US health care system.

Monday, July 21, 2014 | 4:00 p.m. – 5:30 p.m.
Comprehending comprehensive universities

Join us for a panel discussion that seeks to comprehend the comprehensives and to determine the role these schools play in the nation’s college completion agenda.

Tuesday, July 22, 2014 | 8:50 a.m. – 12:00 p.m.
Who governs the Internet? A conversation on securing the multistakeholder process

Please join AEI’s Center for Internet, Communications, and Technology Policy for a conference to address key steps we can take, as members of the global community, to maintain a free Internet.

Event Registration is Closed
Thursday, July 24, 2014 | 9:00 a.m. – 10:00 a.m.
Expanding opportunity in America: A conversation with House Budget Committee Chairman Paul Ryan

Please join us as House Budget Committee Chairman Paul Ryan (R-WI) unveils a new set of policy reforms aimed at reducing poverty and increasing upward mobility throughout America.

Thursday, July 24, 2014 | 6:00 p.m. – 7:15 p.m.
Is it time to end the Export-Import Bank?

We welcome you to join us at AEI as POLITICO’s Ben White moderates a lively debate between Tim Carney, one of the bank’s fiercest critics, and Tony Fratto, one of the agency’s staunchest defenders.

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