Man looking concerned

Breaking news and expert analysis on legal and compliance issues

[Back To Home][Back To Archives]

From Health Reform WK-EDGE, December 18, 2018

Both parties ready to take on larger role in health care policy

By Rebecca Mayo, J.D.

A new study in the New England Journal of Medicine found that the chaotic, hyperpartisanship environment in Washington does not necessarily reflect on the potential for bipartisan agreement on issues surrounding health care at the state level. While Washington may be taking steps to undermine the Affordable Care Act (ACA), the states are claiming an increasingly large role in health policy and Democratic and Republican state policymakers appear to agree on many of the key issues.

The study. Surveys were sent to all state legislators serving on committees related to health, asking them to rank their policy priorities. Kansas was selected to represent the 26 states led entirely by Republicans and Colorado was selected to represent the 18 with split control. Legislators, executive-branch leaders, and key stakeholders were asked about the results of the nationwide survey.

Policymaking. The results of the survey and the discussions with representative states showed that both parties seem agree on many of the key health care reform issues facing states right now. They first noted that leaders expressed near-universal disdain for what was described as a dysfunctional and chaotic environment in Washington which makes it difficult for state leaders to plan for the long-term. Both parties acknowledge that it will be impossible to eliminate the role of government in health care, and turn instead to discussing how the public sector can get the most value for what it spends.

Access and cost. A top priority for policy makers is access to health care, both insurance and providers, especially in rural communities. In some states, Republicans are working to expand Medicaid in order to keep rural hospitals open. From the conversations with policy makers it appears that there may be quibbles about the ACA, but "there does not seem to be an appetite for a large-scale rewrite." Both sides also seem to agree that reducing costs is important, however there are disagreements about the root of the problem and whose costs need to be reduced.

Moving forward. States claiming an increasing role in health policy has the advantage of more closely reflecting local politics. However, durable legislation is more likely to happen with leadership that is less ideologically driven, meaning even in states controlled entirely by one party, bipartisan agreement remains necessary. The authors note that as we enter into this period of state-level experimentation, there is an opportunity to develop evidence about the effects of everything from Medicaid work requirements to housing vouchers and it will be important to develop reliable data about the effects of state decisions.

IndustryNews: NewsStory AccessNews AgencyNews EnrollmentNews EssentialBenefitNews GeneralNews HealthInsuranceExchangeNews MedicaidNews MedicaidExpansionNews

Back to Top

Health Reform / WK-EDGE

Introducing Wolters Kluwer WK-EDGE — created by attorneys, for attorneys — providing timely coverage of breaking news, court decisions, legislation, and regulatory activity.


A complete weekly report of the news that affects your world

  • View full summaries of federal and state court decisions.
  • Access full text of legislative and regulatory developments.
  • Customize your weekly email by topic and/or jurisdiction.
  • Search archives for stories of interest.

Not just news — the right news

  • Get expert analysis written by subject matter specialists—created by attorneys for attorneys.
  • Track law firms and organizations in the headlines with our new “Who’s in the News” feature.
  • Promote your firm with our new reprint policy.

24/7 access for a 24/7 world

  • Forward information with special copyright permissions, encouraging collaboration between counsel and colleagues.
  • Save time with mobile apps for your BlackBerry, iPhone, iPad, Android, or Kindle.
  • Access all links from any mobile device without being prompted for user name and password.