Obamacare Interrupted: Obstructive Federalism and the Consumer Information Blockade
44 Pages Posted: 29 Jul 2014 Last revised: 30 Jul 2014
Date Written: July 27, 2014
Millions of Americans are now insured through the Affordable Care Act (ACA) and implementation forges ahead nationwide. Nevertheless, some states remain defiant. The ACA’s foundation in cooperative federalism lets states embrace or reject some of the laws’ most significant tenets — one such rejection is the southern states’ widely-criticized refusal to expand Medicaid. Less well known and little criticized, however, is certain states’ quiet rejection of a second, equally significant underpinning of the ACA: informational transparency for consumers. Lack of informational transparency means lower enrollment, but also less consumer protection and higher health insurance rates.
This article posits that the states rejecting the ACA’s consumer information provisions are thereby relegating their citizens to a second-class ACA status, in which the ACA’s federally-administered penalties apply but the consumer benefits remain elusive. Part I summarizes the ACA’s goals and the informational transparency provisions designed to help accomplish the goals; Part II explains certain states’ obstructive federalism and how these states are ignoring or undermining the ACA’s transparency provisions; and Part III describes the perverse, secondary results of this rejection and possible means of ameliorating these outcomes.
Keywords: health law, health policy, federalism, Affordable Care Act
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