Watson Institute for International and Public Affairs

Special Issue: The ACA and Beyond

With the release of the latest issue of the Journal of Health Politics, Policy and Law, the Watson Institute asked Editor and Public Policy program Director Eric Patashnik, to share three articles to help understand the current state of the Affordable Care Act.

As the debate over the repeal and replacement of the Affordable Care Act unfolds, the Journal of Health Politics, Policy and Law, based at the Watson Institute, has published a special issue that takes a fresh look at how the ACA has been performing in the American states. Under the ACA, state governments had important decisions to make: whether to create their own health marketplaces, whether to participate in the Medicaid expansion, and whether to reform both their local public health systems and health care delivery systems. What explains the decisions that particular states have made? Have the states been learning from one another? Does evidence of policy effectiveness matter, or do states only take cues from states that share the same political ideology?

Here are three highlights of this special issue (edited by Colleen M. Grogan, David K. Jones, and Julianna Pacheco)

  • Timothy H. Callaghan and Lawrence R. Jacobs, "The Future of Health Care Reform: What Is Driving Enrollment?" Finds that party control dominated early state decision making, but that relative enrollment in insurance exchanges and the Medicaid expansion are driven by a changing mix of political and administrative factors.
  • Craig Volden, "Policy Diffusion in Polarized Times: The Case of the Affordable Care Act" A commentary on the essays contained in this special issue. Argues that the ACA's attempt to leverage the best features of American federalism and promote policy learning has been substantially shaped by the partisan and ideological divides both within and across the states.

Listen to Eric Patashnik on Watson's Trending Globally Podcast:


The Journal of Health Politics, Policy and Law's editorial office is located at Brown University's Watson Institute for International and Public Affairs.