Medicaid: Overview and Impact of New Regulations

Focuses on six new rules aimed at cutting federal spending that could reduce services for vulnerable beneficiaries, slash reimbursement for safety-net providers, and affect states' budgets. Explains current policy, the proposed changes, and their impact

Fiscal Update, March 6, 2007

The Fiscal Division newsletter, published weekly during session and periodically during the interim

Finding Resources for Health Reform and Bending the Health Care Cost Curve

Examines policy options for slowing healthcare spending growth, improving outcomes, and financing comprehensive reform, including changes to Medicare Advantage and hospital pay-for-performance. Compares their estimated budget impact over ten years

Wisconsin: Round 1 - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.The drive to enroll consumers in private health insurance coverage has fostered new alignment among consumer advocates, insurance agents and brokers, community-based organizations, the Wisconsin Department of Health Services, and the health care and insurance sectors. The unique policy position on Medicaid expansion in Wisconsin brings collaboration between those who support the ACA and those who may not support the ACA, but recognize that the governor's entitlement reform plan depends on effective outreach and enrollment into the federally facilitated marketplace. The limited federal funding available for outreach and enrollment has also required public/private partnerships and unlikely alliances. Wisconsin's decision against full Medicaid expansion and instead to cover all adults up to 100 percent of the FPL, but remove adults above that level, provides a boost for the commercial insurance sector. Nearly 80,000 adults will transfer from Medicaid to marketplace coverage and be sent to purchase subsidized coverage on the exchange

Texas: Round 1 - State-Level Field network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.Since the Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010, Texas has reviewed and debated the different policy directives of the legislation. In 2011, Texas decided against administering a state-run health insurance exchange and opted in to a federally run exchange. This decision occurred prior to the Supreme Court decision on the constitutionality of ACA provisions. In 2013, after the 2012 Supreme Court decision allowed states to decide whether to expand Medicaid, Texas chose not to expand Medicaid eligibility and enrollment

Health Reform 2007: Impact on the Valley

Provides a summary of California's health reform debate, background information on recent legislative action, and an overview of the major healthcare proposals pending in the state

Policy Feedback and the Politics of the Affordable Care Act

There is a large body of literature devoted to how “policies create politics” and how feedback effects from existing policy legacies shape potential reforms in a particular area. Although much of this literature focuses on self‐reinforcing feedback effects that increase support for existing policies over time, Kent Weaver and his colleagues have recently drawn our attention to self‐undermining effects that can gradually weaken support for such policies. The following contribution explores both self‐reinforcing and self‐undermining policy feedback in relationship to the Affordable Care Act, the most important health‐care reform enacted in the United States since the mid‐1960s. More specifically, the paper draws on the concept of policy feedback to reflect on the political fate of the ACA since its adoption in 2010. We argue that, due in part to its sheer complexity and fragmentation, the ACA generates both self‐reinforcing and self‐undermining feedback effects that, depending of the aspect of the legislation at hand, can either facilitate or impede conservative retrenchment and restructuring. Simultaneously, through a discussion of partisan effects that shape Republican behavior in Congress, we acknowledge the limits of policy feedback in the explanation of policy stability and change