Most health leaders support federal involvement in reform

When asked their opinion about the authority of states and the federal government over healthcare reform, roughly eight out of 10 leaders in health and healthcare policy said they favored either the balance set by the Affordable Care Act (PPACA) or more authority for the federal government, according to a Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey.

Many of the 1,246 healthcare leaders surveyed expressed concerns, though, about the barriers states face in successfully implementing the law. Nearly nine of 10 (89 percent) said they were concerned or very concerned about the current fiscal situation and budgetary pressures in the states.

In addition, more than 70 percent were concerned about state political resistance and legal challenges (78 percent) and technical knowledge and capacity of state agencies (71 percent).

A majority of the surveyed leaders (61 percent) said they supported--or strongly supported--the creation of a federal health insurance exchange, in addition to the state exchanges that will become operable in 2014.

The healthcare leaders appeared divided, though, on whether states should be given the ability to design their own approaches to healthcare reform--as long as they achieve the same results. About half (49 percent) supported this idea, while 32 percent opposed it, and 18 percent neither supported nor opposed.

For more details:
- see the Commonwealth Fund data brief (.pdf)
- read the Commonwealth Fund overview

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