Obamacare Wars

Federalism, State Politics, and the Affordable Care Act

Häftad, Engelska, 2023

AvDaniel Béland,Philip Rocco,Alex Waddan

379 kr

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Not five minutes after the Affordable Care Act (ACA) was signed into law, in March 2010, Virginia’s attorney general was suing to stop it. And yet, the ACA rolled out, in infamously bumpy fashion, and rolled on, fought and defended at every turn—despite President Obama’s claim, in 2014, that its proponents and opponents could finally “stop fighting old political battles that keep us gridlocked.” But not only would the battles not stop, as Obamacare Wars makes acutely clear, they spread from Washington, DC, to a variety of new arenas. The first thorough account of the implementation of the ACA, this book reveals the fissures the act exposed in the American federal system.Obamacare Wars shows how the law’s intergovernmental structure, which entails the participation of both the federal government and the states, has deeply shaped the politics of implementation. Focusing on the creation of insurance exchanges, the expansion of Medicaid, and execution of regulatory reforms, Daniel BÉland, Philip Rocco, and Alex Waddan examine how opponents of the ACA fought back against its implementation. They also explain why opponents of the law were successful in some efforts and not in others—and not necessarily in a seemingly predictable red vs. blue pattern. Their work identifies the role of policy legacies, institutional fragmentation, and public sentiments in each instance as states grappled with new institutions, as in the case of the exchanges, or existing structures, in Medicaid and regulatory reform.Looking broadly at national trends and specifically at the experience of individual states, Obamacare Wars brings much-needed clarity to highly controversial but little-understood aspects of the Affordable Care Act’s odyssey, with implications for how we understand the future trajectory of health reform, as well as the multiple forms of federalism in American politics.

Produktinformation

Utgivningsdatum2023-02-10
Mått152 x 228 x 13 mm
Vikt272 g
FormatHäftad
SpråkEngelska
Antal sidor232
FörlagUniversity Press of Kansas
ISBN9780700635078

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List of TablesList of FiguresList of AcronymsPrefaceIntroduction1. Postreform Politics in the US Federal System: Patterns of Consent and Dissent2. Uncertain Victory: The Political Context of Health Care Reform Implementation3. Health Insurance Exchanges: When Dissent Means “Not Lifting a Finger”4. Medicaid Expansion: Take It or Leave It5. Regulatory Reform: The Quiet Politics of Bargaining and ConsentConclusionNotesIndex

"Timely, thoughtful, and clearly written, Obamacare Wars offers penetrating insights into how policy legacies, institutional fragmentation, and public sentiments shape post-reform politics."—Eric M. Patashnik, author of Reforms at Risk: What Happens After Major Policy Changes Are Enacted"Ideal for both graduate and undergraduate courses, as well as law, business, and public health programs, the book should be read by anyone trying to understand the post-enactment struggles that have resulted in millions of Americans obtaining new coverage—and millions more waiting for it as their state leaders resist federal intentions."—Jacob S. Hacker, author of Winner-Take-All Politics: How Washington Made the Rich Richer—and Turned Its Back on the Middle Class"Drawing on and arguing with much of what is written about American federalism and health politics, Obamacare Wars makes sense of an intricate and disputed law and sheds new light on the workings, and costs, of American federalism."—Scott L. Greer, author of Territorial Politics and Health Policy "Obamacare Wars offers a deft, timely analysis of state-level battles over the implementation of the Affordable Care Act. This book is an essential read for anyone interested in health policy, federalism, and the political conflicts engendered by both."—Kimberly J. Morgan, coauthor of The Delegated Welfare State: Medicare, Markets, and the Governance of Social Policy "This exceptional book by three leading policy experts tells the fascinating story of the implementation of Obamacare and the myriad ways this landmark legislation is remaking the health care system in the U.S."—Jill Quadagno, author of One Nation, Uninsured: Why the U.S. Has No National Health Insurance