What States Can Do to Preserve Affordable Health Insurance

Daniel Hemel, University of Chicago Law School, Tom Baker, University of Pennsylvania Law School

Whatever happens with “repeal and replace” in the Republican-led Congress, efforts to protect the Affordable Care Act’s expansion of access to quality health insurance are far from over. Two SSNers detail the Trump administration’s potential next moves, and outline specific steps that state policymakers can take to preserve functioning health insurance subsidies and marketplaces.

In a new SSN brief and Vox article, Hemel and Baker illuminate a path for individual states to retain and protect the Affordable Care Act’s most vital provisions, even if the federal government stops trying to make health reform work well. States with the legislative will to do so can ensure their insurance exchanges continue to run smoothly – and stay financially solvent – by stepping in to enforce the individual and employer mandates and provide interim cost-sharing reimbursements to insurers.  Over time, Hemel and Baker’s suggestions would allow states to avoid the skyrocketing costs of caring for newly uninsured residents.


Daniel Hemel is an Assistant Professor of Law at the University of Chicago Law School where he primarily focuses on taxation issues. He previously served as a law clerk to Associate Justice Elena Kagan on the U.S. Supreme Court.

Tom Baker is the William Maul Measey Professor of Law and Health Sciences at the University of Pennsylvania Law School. His scholarship explores insurance, risk, and responsibility using methods and perspectives drawn from economics, sociology, psychology, and history.


April 2017