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The Nelson A. Rockefeller Institute of Government

Saturday, February 17, 2018
ACA Western States

ACA Implementation Research Network

First Regional Reports: Implementation of the Affordable Care Act in Western States

Richard P. Nathan - Project Director

This 35-state field research network on the implementation of the ACA is based at the Nelson A. Rockefeller Institute of Government, the public policy research arm of the State University of New York, and is cosponsored by the Fels Institute of Government at the University of Pennsylvania.

Baseline reports from four regions of the country focus on the start of the initial six-month ACA open enrollment period beginning October 1, 2013. The first report examines the Western region where the state governments have generally embraced the ACA. Nine states in the region are in the network sample, six of which have affirmed the law by choosing to operate their own health insurance exchanges and expand their Medicaid programs.

Using a common research format, researchers have produced reports from Arizona, California, Colorado, Idaho, Oregon, New Mexico, Nevada and Washington. You may open the state reports by clicking on their names above or on the map below.

In an overview report, John Stuart Hall describes and compares the sample states in the Western region. The overview report may be accessed here.

Next steps

The next regional report will be on the Southern states, most of which chose not to expand Medicaid or set up their own health insurance exchanges. The sample includes nine oppositional Southern states and two affirming Southern states. Regional baseline reports are also planned for the Midwest and Northeast.

As the fourth anniversary of the signing of the Affordable Care Act approaches, signs of change, along with patterns of the law's effects, are emerging. But it will take a long time to assess the law's ultimate effects. Members of the Rockefeller-Fels field research network – in collaboration with other experts and organizations – intend to track these many policy, institutional, and administrative developments in the long run.

This is an exciting time for American government. The enactment of the Patient Responsibility and Affordable Care Act four years ago has caused an eruption of interest and action on the part of citizens and scholars to learn what is happening under the new law. The Affordable Care Act puts in place a historic new component of the nation’s social safety net. What we bring to this moment is the capacity, over time, to describe and interpret the implementation of the ACA. A more in-depth description of the project can be found here.

Reports for the Southern states may be accessed by going to

Washington Idaho Montana Wyoming Colorado NewMexico Arizona Utah Oregon Nevada California