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Understanding Obamacare: States Have Flexibility to Deliver Health Care

Dec. 16, 2013
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Question: Can states improve upon the Obamacare?

Answer: Yes. From the beginning, advocates had pushed to allow states the option of going above and beyond the requirements of the Affordable Care Act, provided it covered equal or more people and it invested wisely. That guarantee is in Obamacare. This law provides the new ground floor for health care in this country, but states can build upon that.

And many states have. States can choose whether to create their own marketplace, and states like Wisconsin can change their mind and accept federal Medicaid funds at any time if they haven’t already. But the options don’t stop there. Vermont, for instance, decided to create the first U.S. single-payer “universal” health system guaranteeing that every citizen has access to affordable, quality health care. Other states, like Wisconsin, have urged the use of multiple insurance companies, arguing that private insurers can provide the best coverage. Which system is best will be seen over time, allowing America to identify the best mechanism for providing affordable health care for all.

States will truly be the vehicle for moving reform forward. California passed a rule that those overseeing their state’s marketplace, Covered California, cannot work for an insurance company in order to prevent bias. Rhode Island will allow small business employees the option of choosing through multiple plans, and not be limited to just one plan. And states like Minnesota have found better ways to cover their low- and moderate-income residents, providing better and more affordable options.

This matters greatly. Some states will figure out innovative ways to improve care and cost. It is important to learn from them. Our neighbors in other states already pay less, and Wisconsin costs are higher than the national average. The Affordable Care Act makes states the new laboratories of health reform, allowing us to improve access even more to quality affordable care.

—Kevin Kane, lead organizer, Citizen Action of Wisconsin



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