About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

15 Ind. Health L. Rev. 1 (2018)

handle is hein.journals/inhealr15 and id is 1 raw text is: Indiana Health Law Review Volume XV 2018 Number 1 ARTICLES THE NEW HEALTH CARE FEDERALISM ON THE GROUND ABBE R. GLUCK & NICOLE HUBERFELD* I. INTRODUCTION The central question posed by this symposium concerns the methods of evaluating health policy. Our empirical work on that topic centers on American health care federalism, the relationship between the federal and state governments in the realm of U.S. health care policy and regulation. We recently completed a five-year study tracking implementation of the Patient Protection and Affordable Care Act (ACA) from 2012-2017.1 The study focused on the two key pillars of the ACA, which also happen to be the most state-centered aspects of the law. Those pillars are the expansion of Medicaid-the U.S. health insurance program for low-income individuals, originally established in 1965-and the implementation of the ACA's new insurance marketplaces, known as health insurance exchanges. Our results shed light on what we call the new health care federalism- federalism in the modern era of nationally enacted health laws that preserve key roles for state leadership. At the same time, our study reveals the theoretical and empirical challenges of quantitatively evaluating health care federalism at all. What is it really? Does it exist? It is successful? Why do we choose federalism-oriented models in the first place? The full study and its implications are presented in a forthcoming article in the Stanford Law Review.2 Our purpose here is to offer a more accessible snapshot; to discuss the methodological challenges we faced; and to offer in more detail than the longer article one aspect of our methodology: interviews of approximately twenty high ranking former state and federal officials who were at the forefront of the first years of ACA implementation. What we heard from * Professor of Law and Faculty Director, Solomon Center for Health Law and Policy, Yale Law School; Professor of Health Law, Ethics & Human Rights, Boston University School of Public Health & Professor of Law, Boston University School of Law. We are deeply thankful to our interviewees for their insights, candor, and time, and to our colleagues in the Indiana Health Law Program for the invitation. 1. We began the work of studying implementation with colleagues at the University of Pennsylvania, Tom Baker and Theodore Ruger, in a project we detail in the Stanford Law Review. We are indebted to them for their contributions. 2. Abbe R. Gluck& Nicole Huberfeld, What Is Federalism in Health Care For?, 70 STAN. L. REv. _ (forthcoming 2018).

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Purchase Access

Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most