Health Care Reform And A Failed Vision Of Bipartisanship.

The Affordable Care Act transformed health care in the United States. What hasn't changed is the partisan landscape in which it became law.

How Insurers Competed in the Affordable Care Act's First Year.

Prior to the Affordable Care Act (ACA), most states' individual health insurance markets were dominated by one or two insurance carriers that had little incentive to compete by providing efficient services. Instead, they competed mainly by screening and selecting people based on their risk of incurring high medical costs. One of the ACA's goals is to encourage carriers to participate in the health insurance marketplaces and to shift the focus from competing based on risk selection to processes that increase consumer value, like improving efficiency of services and quality of care. Focusing on six states--Arkansas, California, Connecticut, Maryland, Montana, and Texas--this brief looks at how carriers are competing in the new marketplaces, namely through cost-sharing and composition of provider networks.

Implementing health reform: four years later.

Despite enormous potential, the Affordable Care Act has been plagued by controversy and confusion from day one.

Employers and the exchanges under the small business health options program: examining the potential and the pitfalls.

The health insurance exchange is the centerpiece of the insurance reforms created by the Affordable Care Act. The Small Business Health Options Program (SHOP) is intended to create a marketplace for small, and perhaps eventually large, employers to purchase health insurance for their employees. This paper introduces a collection of articles that illuminate the need for small-business exchanges and discuss how they will function. The paper also describes the difficulties these exchanges will face, as well as the opportunities they will offer to states, employers, and individuals. The success or failure of small-business exchanges may well hinge on how states choose to address these challenges.

Pro & con. State lawsuits won't succeed in overturning the individual mandate.

The Patient Protection and Affordable Care Act of 2010 looks to the states to implement its insurance regulatory reforms and exchanges, retaining for the national government what could be construed as merely a backup role. The law offers federal support to the states, along with opportunities to act creatively to meet residents' needs. It thus is unfortunate that a number of states have responded by challenging the law, both legislatively and judicially, rather than getting on with implementation. These challenges have no legal merit and are a serious distraction from the real work that lies before the states.

Health care reform requires law reform.

Health care financing and delivery reform seems to be under way. Reform will in all likelihood originate with Congress but may also come from the states or even the private sector. Federal law, however, limits states' options for reform, while state law constrains federal reform, and both state and federal law impede private innovation. Congressional action could facilitate state reform. Alternatively, federal preemption of state law may be necessary for federal reform. If neither Congress nor the states act, action by federal agencies could support private innovation. In any event, law reform is a necessary condition for health reform.