State and National Health Care Reform: A Case for Federalism

Because the new U.S. President, Barack Obama, campaigned on a platform that prominently featured health reform, and is welcomed to Washington by a Congress that has put health care near the top of its agenda, interest in and energy around broad federal health reform is gaining momentum. A sense of optimism by reform advocates has remained, even in the face of the nation’s dismal economic situation. If health reform does move forward, policymakers will need to find a balance between the role of states, who have traditionally led the movement to reduce costs, expand access and improve quality, and the federal government, which has provided the policy setting and financial foundation for such reforms.

Within our structure of federalism and given the complexity of the health care system, it is imperative to build upon the respective strengths of both state and federal governance to fashion health reform solutions with the greatest potential for success.^[i] This section looks at the strengths of states and the federal government, and outlines a potential framework for merging the two, informed by a growing body of research based on state reform efforts.

• Continue reading on: Implementation, System Redesign, and Other State Strengths [1]
• Other Sections in State and National Health Reform: A Case for Federalism: 

Implementation, System Redesign, and Other State Strengths [2], Financing, Continuity, and Other Federal Strengths [3], A Federal-State Partnership [4], State Variation in the Context of Federal Reform [5], Conclusion: Building a Strong State-Federal Partnership [6]

[2]