Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-xfwgj Total loading time: 0 Render date: 2024-06-22T09:43:20.598Z Has data issue: false hasContentIssue false

7 - Progressive Federalism and the Contested Implementation of Obama’s Health Reform

Published online by Cambridge University Press:  05 November 2014

Lawrence R. Jacobs
Affiliation:
University of Minnesota
Theda Skocpol
Affiliation:
Harvard University
Jeffery A. Jenkins
Affiliation:
University of Virginia
Sidney M. Milkis
Affiliation:
University of Virginia
Get access

Summary

At a celebratory ceremony held in the East Room of the White House on March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act of 2010 – potentially a landmark in U. S. social provision comparable to the Social Security Act, Civil Rights Act, and enactment of Medicare and Medicaid. “Potentially a landmark” was, however, the right way to think of the reform when first signed into law. This comprehensive measure promised to regulate private health insurance and extend affordable coverage to more than 30 million Americans, mostly people with low or lower-middle incomes. But these reforms would not be fully implemented until 2014–2019, and the law had to run perilous legal and partisan gauntlets first. The presidential signing ceremony came at the end of fifteen contentious months of partisan and interest group maneuvering in Congress, and launched the fledgling law into new rounds of legal challenges, plus efforts by conservative Republicans to win sufficient leverage in the November 2012 elections to repeal or eviscerate health reform before its major provisions went into full effect.

To the surprise of some, the Affordable Care Act survived the early death threats. The Supreme Court upheld its core provisions on June 28, 2012, and President Barack Obama was reelected on November 6, 2012, reinstalled in Washington, DC, along with a strong majority of Democratic Senators. Although Republicans determined to frustrate the implementation of Affordable Care at every turn remain in charge of the House of Representatives, the legal framework and much of the programmed funding for comprehensive health reform are here to stay. Led by the capable and savvy Secretary Kathleen Sebelius, Obama’s Department of Health and Human Services (DHHS) continues to work out regulatory details in negotiations with major interest groups, while much of the administrative and political drama shifts to the fifty U. S. states, which will have a lot to say about the implementation and success of reforms in coming years.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jacobs, Lawrence and Skocpol, Theda. 2012. Health Care Reform and American Politics. New York: Oxford University PressGoogle Scholar
Jacobs, Lawrence and Ario, Joel. December 2012. “Postelection, The Affordable Care Act Leaves the Intensive Care Unit for Good.” Health Affairs. 31: 2603–2608CrossRefGoogle Scholar
Lieberman, Robert C. 2001. Shifting the Color Line: Race and the American Welfare State. Cambridge, MA: Harvard University PressGoogle Scholar
Hertel-Fernandez, Alexander. February 2012. “Why U. S. Unemployment Insurance Is in Financial Trouble.” Basic Facts brief, Scholars Strategy NetworkGoogle Scholar
Orren, Karen and Skowronek, Stephen. 2004. The Search for American Political Development. Cambridge: Cambridge University Press, 20CrossRefGoogle Scholar
Skocpol, Theda. 1992. Protecting Soldiers and Mothers: The Politics of Social Provision in the United States, 1870s-1920s. Cambridge: Harvard UniversityGoogle Scholar
Mettler, Suzanne and Soss, Joe. 2004. “The Consequences of Public Policy for Democratic Citizenship: Bridging Policy Studies and Mass Politics.” Perspectives on Politics. 2 (March): 55–73CrossRefGoogle Scholar
Pierson, Paul. October 1995. “Fragmented Welfare States: Federal Institutions and the Development of Social Policy.” Governance. 8: 449–478CrossRefGoogle Scholar
Tiebout, Charles. 1956. “A Pure Theory of Local Expenditures.” Journal of Political Economy. 64: 416–424CrossRefGoogle Scholar
Breton, Albert. 1987. “Towards a Theory of Competitive Federalism.” European Journal of Political Economy. 3: 263–329CrossRefGoogle Scholar
Kenyon, Daphne and Kincaid, John (eds.). 1991. Competition among States and Local Governments: Efficiency and Equity in American Federalism. Washington, DC: Urban Institute
Brown, Carrie. October 22, 2009. “Nelson: Reid, WH ‘Leaning Toward’ Public Option.” Politico. Retrieved from
Chandler, William M. and Bakvis, Herman. 1989. “Federalism and the Strong-State/Weak-State Conundrum: Canadian Economic Policymaking in Comparative Perspective.” Publius. 19(1): 59–78CrossRefGoogle Scholar
Robertson, David Brian. 1989. “The Bias of American Federalism.” Journal of Policy History. 1: 262–291CrossRefGoogle Scholar
Grogan, Colleen and Patashnik, Eric. October 2003. “Between Welfare Medicine and Mainstream Entitlement: Medicaid at the Political Crossroads.” Journal of Health Politics, Policy, and Law. 28: 821–858CrossRefGoogle ScholarPubMed
Pear, Robert and Herszenhorn, David. August 6, 2009. “Senators Hear Concerns over Costs of Health Proposal.” New York Times. Retrieved from
Krauss, Clifford. August 7, 2009. “Governors Fear Added Costs in Health Care Overhaul.” New York Times.
Young, Jeffrey. August 6, 2009. The Hill
Rosenbaum, Sara. 1993. “Medicaid Expansions and Access to Health Care” in Medicaid Financing Crisis ed. by Rowland, Diane, Feder, Judith, and Salganicoff, Alina. Washington, DC: AAAS Press, 45–82Google Scholar
Jacobs, and Skocpol, , Health Care Reform and American Politics, 2012
Brown, Lawrence and Sparer, Michael. January 2003. “Poor Program’s Progress: The Unanticipated Politics of Medicaid Policy.” Health Affairs. 22: 31–44CrossRefGoogle ScholarPubMed
Pierson, Paul. June 2000. “Increasing Returns, Path Dependence, and the Study of Politics.” American Political Science Review. 94: 251–267CrossRefGoogle Scholar
Skocpol, Theda and Ikenberry, John. 1983. “The Political Formation of the American Welfare State in Historical and Comparative Context.” Comparative Social Research. 6: 87–148Google Scholar
U.S. Government Accounting Office. 2011. Private Health Insurance: State Oversight of Premium Rates. (GAO-11-701). Washington: Government Printing OfficeGoogle Scholar
Jacobson, Louis. April 12, 2011. “Insurance Commissioners Prepare for Health Care Policy Conflicts.” Governing. Retrieved from
Kliff, Sarah and Haberkorn, Jennifer. October 21, 2011. “State Health Officials Approve Key Reform Plan.” Politico. Retrieved from
Kliff, Sarah. March 30, 2011. “Tea Party Notches Health Reform Wins.” Politico. Retrieved from
Aizenman, N. C. December 8, 2012. “GOP Governors Seek Leeway on Medicaid Expansion.” Washington Post
Radnovsky, Louise. December 11, 2012. “Feds Nix Partial Medicaid Expansion.” Wall Street Journal. A6Google Scholar
Kliff, Sarah. November 15, 2012. “States Get More Time to Decide Whether to Build Health Exchanges.” Washington Post
Radnovsky, Louise. November 21, 2012. “States Get a Say in Health Law.” Wall Street Journal. A4Google Scholar
Jacobs, Lawrence and Mettler, Suzanne. 2011. “Why Public Opinion Changes: The Implications for Health and Health Policy.” Journal of Health Policy, Politics and Law; Kaiser Family Foundation. 2012, 917–933. “Kaiser Tracking Poll.” Retrieved from CrossRefGoogle ScholarPubMed
Capretta, James C. and Levin, Yuval. November 19, 2012. “Why ObamaCare Is Still No Sure Thing.” Wall Street Journal. A19Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×