The Launch of Health Reform in Eight States: State Flexibility Is Leading to Very Different Outcomes

Research Report

The Launch of Health Reform in Eight States: State Flexibility Is Leading to Very Different Outcomes

Abstract

This paper provides a review of a series of papers that examine early implementation of the Affordable Care Act in 8 states. These states Alabama, Colorado, Maryland, Michigan, Minnesota, New York, Oregon, and Virginia have made very different design choices in implementing the law. We examine coverage expansion; financial impacts; the development of information technology systems; outreach, education and enrollment assistance; insurer participation, competition and premiums in marketplaces; insurance market reforms; development of SHOP marketplaces; and issues of provider capacity. We conclude that different design choices made by states will lead to different results. The law will work very differently for residents in different states around the country and there will be different outcomes both in terms of coverage and economic impacts.

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