March 2014
The U.S. Census Bureau defines four main regions of the country — the West, South, Midwest, and Northeast. This first “Special Analysis Report” focuses on the Western region, which has the largest number of states — six out of thirteen — that are affirmatively implementing the Affordable Care Act. That is, they have state-administered health insurance exchanges and have expanded Medicaid as authorized under the law.
Altogether, there are eleven states in the Western region of the contiguous states, and nine of them are in our sample. A complete list of states of the Western region and those of our sample is contained in Table 1 (see next page).
This report describes the policy setting and goal alignment of all nine Western sample states, with emphasis on five states — California, Oregon, Washington, Colorado, and Nevada — that are clearly out front as ACA-affirming states. New Mexico is also an affirming ACA state, although its exchange will not be state run until 2014. Arizona and Idaho occupy an “In-Between” category; that is, in between affirming and oppositional. Arizona rejected the state-run exchange option but accepted Medicaid expansion. Idaho so far has done the opposite, accepting the state-run exchange option while tabling Medicaid expansion. Utah is the one fully oppositional state in our sample, choosing in 2013 not to run its exchange or expand Medicaid. As shown in Table 1, by one index of “enrollment performance” (the number of individuals who have selected a plan as a percentage of the potential market size during the first month of operation) four of the six fully affirming Western states rank among the top ten states.
The field research reports described in this Special Analysis Report contain individual state stories and baseline data covering the first month of exchange operations under the Affordable Care Act. The information can be accessed from the Special Analysis Report or by using the network map available on the project Web site (http://www.rockinst.org/aca/). Initial Round 1 reports for sample states from other regions will be announced and posted along with future Special Analysis Reports. You can receive announcements of both types of reports by emailing [email protected].
