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Health Care Opinion Leaders’ Views on Health Reform and the Role of States

When asked about the relative power of states and the federal government over health reform, seven of 10 leaders in health care and health care policy favor the balance set by the Affordable Care Act or more authority for the federal government, according to a Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey. A majority of leaders supports granting more federal authority over health insurance market rules and provider payment methods, while just two of 10 favor granting states more power over the individual mandate provision contained in the law. Survey respondents are concerned with several barriers to successful implementation of the act, including the current fiscal situation and budgetary pressures in many states. Six of 10 leaders support creating a federal health insurance exchange in addition to state exchanges, and more than 80 percent support allowing states to implement key provisions ahead of the original timelines outlined in the law.

Publication Details

Publication Date: May 23, 2011

K. Stremikis, K. Davis, R. Nuzum, and E. L. Schor, Health Care Opinion Leaders’ Views on Health Reform and the Role of States, The Commonwealth Fund, May 2011.


Associate Director for Policy, Pacific Business Group on Health
Professor Emerita in the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
Rachel Nuzum
Vice President, Federal and State Health Policy, The Commonwealth Fund
Senior Vice President for Programs and Partnerships, Lucile Packard Foundation for Children's Health