Affordable Care Act Repeal Efforts Would Impact State Laws, Too

By Kevin Lucia and Katie Keith

With much of the attention over ACA repeal efforts focused on Washington DC, it’s easy to forget that repeal-and-replacement efforts would significantly affect state approaches to insurance regulation. This is especially true in the 32 states and D.C. that have adopted state-level ACA protections.

While some state legislatures have begun to reconsider how they regulate their insurance markets based on Congress’ pledge to repeal the ACA, doing so without a replacement plan in place could be challenging.

In particular, states may want to retain their current ACA protections and enforcement authority to maintain stability in their insurance market and avoid any regulatory or enforcement gaps during the transition. State policymakers may also want to maintain (or, if they have not yet done so, adopt) some of the ACA’s market reforms, many of which continue to be viewed favorably even across party lines.

Because Congress has not yet enacted or even coalesced around a single federal replacement plan, state policymakers should exercise caution before making changes in state law.

Read more in The Commonwealth Fund’s To the Point blog.





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