Hybrid Federalism, Partisan Politics, and Early Implementation of State Health Insurance Exchanges

Elizabeth Rigby and Jake Haselswerdt

Publius: The Journal of Federalism, 2013, vol. 43, issue 3, 368-391

Abstract: A central provision of the Affordable Care Act is establishment of state-level health exchanges. While states are given the opportunity to develop and administer these private insurance marketplaces, their plans must meet certain minimum standards or risk preemption by the federal government. This policy design establishes a hybrid model of intergovernmental policy making, which may serve to heighten conflict during implementation and further polarize states' policies. Using new data on states' efforts to establish exchanges and repeated-events duration modeling, we examine states' early exchange implementation--identifying a key role for ideological and partisan considerations, as well as the implications of a federal policy design that puts conservative states in the difficult political position of choosing between resisting a law they oppose and preventing further federal intrusion. Copyright 2013, Oxford University Press.

Date: 2013
References: Add references at CitEc
Citations: View citations in EconPapers (5)

Downloads: (external link)
http://hdl.handle.net/10.1093/publius/pjt012 (application/pdf)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:oup:publus:v:43:y:2013:i:3:p:368-391

Ordering information: This journal article can be ordered from
https://academic.oup.com/journals

Access Statistics for this article

Publius: The Journal of Federalism is currently edited by Paul Nolette and Philip Rocco

More articles in Publius: The Journal of Federalism from CSF Associates Inc. Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, UK.
Bibliographic data for series maintained by Oxford University Press ().