December 2020 | Sara Rosenbaum, Heidi L. Allen, Joel C. Cantor | Using State Reform Demonstrations to Build Back Better
The ambition of the Biden-Harris campaign’s national health reform plan is easy to overlook, in part, because of the relatively modest sound of an agenda framed as “Building on the Affordable Care Act,” as the campaign had pledged. But the plan is actually far from modest, particularly in light of the extraordinary political conditions that the incoming administration likely will confront. Certain key elements would require either an unprecedented level of bipartisanship or a Democratic majority in both houses of Congress, neither of which seems likely. Because states historically have been the proving ground for blueprints in health reform, a key question will be whether, and how, the new administration might leverage its considerable administrative powers to facilitate testing big ideas through state experimentation.