The Out-Front Western Region: An Overview

by John Stuart Hall

Mar 1, 2014
This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network ---- with 36 states and 61 researchers ---- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.

This first "Special Analysis Report" focuses on the Western region, which has the largest number of states -- six out of thirteen -- that are affirmatively implementing the Affordable Care Act. That is, they have state-administered health insurance exchanges and have expanded Medicaid as authorized under the law. Altogether, there are eleven states in the Western region of the contiguous states, and nine of them are in our sample. This report describes the policy setting and goal alignment of all nine Western sample states, with emphasis on five states -- California, Oregon, Washington, Colorado, and Nevada -- that are clearly out front as ACA-affirming states. New Mexico is also an affirming ACA state, although its exchange will not be state run until 2014. Arizona and Idaho occupy an "In-Between" category; that is, in between affirming and oppositional. Arizona rejected the state-run exchange option but accepted Medicaid expansion. Idaho so far has done the opposite, accepting the state-run exchange option while tabling Medicaid expansion. Utah is the one fully oppositional state in our sample, choosing in 2013 not to run its exchange or expand Medicaid.
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