Today, Health Affairs released the first installment of Health Affairs Conversations, a new periodic series of podcasts featuring discussions with health policy experts and Health Affairs contributors. We begin with a discussion of the implementation of the Affordable Care Act with Timothy Jost and Gail Wilensky. Tim is the Robert L. Willet Family Professor of Law at Washington and Lee University School of Law, a member of the Institute of Medicine, and a Health Affairs Contributing Editor who has authored an extensive series of Health Affairs Blog posts on ACA implementation. Gail is a senior fellow at Project Hope, Health Affairs’ parent organization. She is also an IOM member and ran Medicare and Medicaid under President George H.W. Bush. (Please note that the podcast file is large and, in some systems, may take some time to begin playing or downloading.)
In a wide-ranging 40-minute conversation with me, Tim and Gail both note that the initial premium results from plans that are participating in the various state health insurance marketplaces have been lower than expected. They talk about some of the challenges to the sustainability of these promising results, where premiums might be headed in the future, and what the risk pools in the exchanges might look like.
Tim and Gail also discuss the immense organizational and technological tasks that the states and the federal government face in implementing the ACA. They observe that the ACA presents challenges that dwarf those posed by other complex health policy statutes, such as the Medicare drug benefit. Moreover, in contrast to the bipartisan cooperation that helped make the drug benefit work, in today’s politically polarized environment ACA opponents are actively working against the new law.
Tim and Gail examine the difficulties presented by this political environment, notably the lack of adequate implementation funding and the expectation that the inevitable bumps in the road will become issues in the campaigns of 2014 and beyond. They also note the confusion and misinformation about the ACA among members of the public, including those who might benefit most from the law.
Listen to the Tim and Gail discuss these and other topics. You can also listen to this and other Health Affairs podcasts in iTunes. And watch for future installments of Health Affairs Conversations.