Simon F. Haeder is a doctoral student in Political Science and a Master’s student in Agricultural and applied Economics at the University of Wisconsin-Madison. His research interests include healthcare policy, regulatory policy-making, and theories of the policy process. He is currently working on several research projects in health policy focusing on the implementation of the Affordable Care Act and insurance regulation. He is also investigating the incidence and effect of regulatory lobbying.
As the Affordable Care Act is likely to persist, we should shift our attention toward actually making it work. However, this may be even more challenging than overcoming the initial political opposition. One of the most daunting problems is to make fifty-one insurance exchanges (marketplaces) across the country into viable, self-sufficient, and effective entities. Consumer demographics pose a significant challenge to these marketplaces, one that may lead to their demise. Ultimately, it may be prudent to continue high-risk pools as a supplement to marketplaces in order to offer lower premiums in the marketplaces and provide an opportunity for learning. This strategy could be made acceptable to both Republicans and Democrats.
Blewett, Lynn A., and Donna Spencer. 2008. State High Risk Pools: An Overview. Minneapolis, MN: State Health Access Data Assistance Center.
Cauchi, Richard. 2012. Coverage of Uninsurable Pre-Existing Condit Ions: State and Federal High-Risk Pools. Denver, CO: National Conference of State Legislatures.
Center for Consumer Information & Insurance Oversight. 2013. Covering People with Pre-Existing Conditions: Report on the Implementation and Operation of the Pre-Existing Condition Insurance Plan Program. Washington, DC: Centers for Medicare & Medicaid Services, U.S. Department of Health & Human Services.
Chollet, Deborah J. 2010. “How Temporary Insurance for High-Risk Individuals May Play out under Health Reform.” Health Affairs 29 (6): 1164–1167.
Gardiner, Terry. 2012. “Health Insurance Exchanges of Past and Present Offer Examples of Features That Could Attract Small-Business Customers.” Health Affairs 31 (2): 284–289.10.1377/hlthaff.2011.1006)| false
Hadley, Jack, John Holahan, Teresa Coughlin, and Dawn Miller. 2008. “Covering the Uninsured in 2008: Current Costs, Sources of Payment, and Incremental Cost.” Health Affairs 27 (5): w399–w415.
Haeder, Simon F. 2012. “Beyond Path Dependence: Explaining Healthcare Reform and Its Consequences.” Policy Studies Journal 40 (S1): 65–86.
Haeder, Simon F. 2012. “Beyond Path Dependence: Explaining Healthcare Reform and Its Consequences.” Policy Studies Journal 40 (S1): 65–86.10.1111/j.1541-0072.2012.00446.x)| false
Haeder, Simon F., and David L. Weimer. 2013. “You Can’t Make Me Do It: State Implementation of Insurance Exchanges under the Affordable Care Act.” Public Administration Review. doi: 10.1111/puar.12065.
Haeder, Simon F., and David L. Weimer. 2013. “You Can’t Make Me Do It: State Implementation of Insurance Exchanges under the Affordable Care Act.” Public Administration Review. doi: 10.1111/puar.12065.10.1111/puar.12065)| false
Hall, Jean P., and Janice M. Moore. 2012. Realizing Health Reform’s Potential: The Affordable Care Act’s Pre-Existing Condition Insurance Plan: Enrollment, Costs, and Lessons for Reform. New York: The Commonwealth Fund.
Hall, Mark A. 2012. “Regulating Stop-Loss Coverage May Be Needed to Deter Self- Insuring Small Employers from Undermining Market Reforms.” Health Affairs 31 (2): 316–323.
Hall, Mark A. 2012. “Regulating Stop-Loss Coverage May Be Needed to Deter Self- Insuring Small Employers from Undermining Market Reforms.” Health Affairs 31 (2): 316–323.10.1377/hlthaff.2011.1017)| false
Henry J. Kaiser Family Foundation. 2011. A Profile of Health Insurance Exchange Enrollees. Menlo Park, CA: Henry J. Kaiser Family Foundation.
Kramer, William E. 2012. “Large Employers See Scenarios under Which They Could Move Workers and Retirees to Exchanges.” Health Affairs 31 (2): 299–305.
Laudicina, Susan S. 1988. “State Health Risk Pools: Insuring the ‘Uninsurable’.” Health Affairs 7 (4): 97–104.10.1377/hlthaff.7.4.97)| false
Le Grand, Julian. 2007. The Other Invisible Hand: Delivering Public Services through Choice and Competition. Princeton, NJ: Princeton University Press.
Le Grand, Julian. 2010. “Knights and Knaves Return: Public Service Motivation and the Delivery of Public Services.” International Public Management Journal 13 (1): 56–71. doi: 10.1080/10967490903547290.
Le Grand, Julian. 2010. “Knights and Knaves Return: Public Service Motivation and the Delivery of Public Services.” International Public Management Journal 13 (1): 56–71. doi: 10.1080/10967490903547290.10.1080/10967490903547290)| false
Merline, John. 2013. “Obamacare Exchange Subsidy Cost Hiked by $233 Billion.” Investors Business Daily, February 5.
Monahan, Amy, and Daniel Schwarcz. 2011. “Will Employers Undermine Health Care Reform by Dumping Sick Employees?” Virginia Law Review 97: 125–197.
Mulvey, Janemarie. 2013. Potential Employer Penalties under the Patient Protection and Affordable Care Act (ACA). Washington, DC: Congressional Research Service.
Mulvey, Janemarie, and Hinda R. Chaikind. 2012. Individual Mandate and Related Information Requirements under ACA. Washington, DC: Congresional Research Service.
Nather, David, and Carrie Budoff Brown. 2011. “Republicans Eye Costs, Not Uninsured.” Politico, January 24.
Pauly, Mark V. 2008. “Blending Better Ingredients for Health Reform.” Health Affairs 27 (6): w482–w491.
Pauly, Mark V. 2008. “Blending Better Ingredients for Health Reform.” Health Affairs 27 (6): w482–w491.10.1377/hlthaff.27.6.w482)| false
Pecquet, Julian. 2010. “Abortion Coverage Restricted in High-Risk Insurance Pools.” The Hill, July 29.
Pressman, Jeffrey L., and Aaron Wildavsky. 1973. Implementation: How Great Expectations in Washington Are Dashed in Oakland; or, Why It’s Amazing That Federal Programs Work at All, This Being a Saga of the Economic Development Administration as Told by Two Sympathetic Observers Who Seek to Build Morals on a Foundation of Ruined Hopes. Berkeley: University of California Press.
PricewaterhouseCoopers Health Research Institute. 2011. Change the Channel: Health Insurance Exchanges Expand Choice and Competition.
Stawicki, Elizabeth. 2011. “Study: Employers Could Dump Sickest Employees on Public Health Care.” Kaiser Health News, November 30.
U.S. Government Accountability Office. 2012. Comparison of Implementation and Early Enrollment with the Children’s Health Insurance Program. Washington, DC: U.S. Government Accountability Office.
Vestal, Christine. 2011. “High-Risk Health Care Plans Fail to Draw Crowd.” Stateline, September 6.
This journal provides a forum for professionally informed commentary on issues affecting contemporary American politics. This includes but is not limited to issues engaging parties, elections, and political participation; the news media, interest groups, Congress, the Presidency, and the Courts; trends in public finance, presidential popularity, congressional productivity; in contemporary, historical, or comparative perspective.