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The Nelson A. Rockefeller Institute of Government

Saturday, February 17, 2018
ACA Southern States

ACA Implementation Research Network

Regional Reports: Implementation of the Affordable Care Act in Southern 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 Brookings Institution and the Fels Institute of Government at the University of Pennsylvania.

The latest regional report are 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. Using a common research format, researchers have produced reports from Alabama, Florida, Kentucky, Maryland, South Carolina, Texas and West Virginia. You may open the state reports by clicking on their names above or on the map below.

In an overview report, Christopher Plein describes and compares the sample states in the southern region. The overview report may be accessed here.

Next steps

Regional baseline reports are also planned for the Midwest and Northeast.

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-Brookings-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 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 Western states, previously released, may be accessed by going to

Deleware Maryland Virginia North Carolina South Carolina Georgia Florida Alabama Tennessnn Kentucky West Virginia Mississippi Louisiana Arkansas Oklahoma Texas