The State(s) of Health: Federalism and the Implementation of Health Reform in the Context of HIV Care

摘要: Although the federal government will finance most of coverage expansions Patient Protection and Affordable Care Act (ACA), implementation is largely devolved to states. Drawing from interviews with HIV policy experts program managers a documents review, authors enumerate actions that must occur at multiple levels in order for ACA context care improve access health outcomes conditions under which these may fall short. Positive are predicted patients states sufficient political support resources implement ACA. However, worsen do not Medicaid expansion or other provisions, particularly if funding discretionary safety net programs reduced. Transitioning HIV-specific sources also reduce services previously were forefront care.