The Rebirth of Federalism: Slouching toward Washington

James, Joseph A.; Walker, David B.

doi:10.2307/3380606

Cited by 4 publications

(1 citation statement)

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“…As a platform for policy innovation, the Act is continuing a function that allowed Medicare, Medicaid, or the State Children's Health Insurance Program to be enacted. These and other programs reflect the interesting combination of both centripetal and centrifugal forces in American federalism that have at times created tensions in intergovernmental relations (Walker 1999). Medicare and Medicaid, respectively, reflect both the centralized and decentralized nature of public health and social insurance approaches in the United States.…”

Section: Practicalities: Aca's Intergovernmental Architecturementioning

confidence: 99%

An Uncertain Federalism: The States and the Affordable Care Act

Plein

2014

Journal of Health and Human Services Administration

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This article provides an initial assessment of the Affordable Care Act's recent implementation experience in the states. Drawing on state-level and regional analyses that have been coordinated by the ACA Implementation Network – a cooperative effort involving researchers in 35 states – this article highlights the uncertain policy environment associated with the politics and complexities of the ACA. Understanding the ACA implementation experience requires an appreciation for political context, but must also take into account underlying demographic, market, and state administrative capacity issues in the states. There are indications that the ACA implementation experience is moving from a highly charged partisan nature to a more accommodating posture long associated with intergovernmental relations between the federal and state government in health and human services administration. in short, the key questions going forward will turn on how, not whether, the ACA is implemented.

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Section: Practicalities: Aca's Intergovernmental Architecturementioning

confidence: 99%