Partisanship, Support for Health Reform, and State Opposition to the Patient Protection and Affordable Care Act

This paper analyzes the critique of ACA that it unjustifiably interferes with state efforts at health reform. We address several aspects of this critique: the argument by states that ACA prematurely cuts off vibrant health reform at the state level by looking at a number of areas in which health change reform is being addressed at both the state and federal level; our examination extends beyond the issue of access that has largely captured the political debates. We do this by examining state support for litigation challenging ACA in comparison with the state's actual efforts at reform. Our data suggest that state support for the challenges to ACA is not explained by state level reform efforts, but by partisanship and low levels of support for Medicaid itself