VUKADIN — Volume 63, Issue 3

The Affordable Care Act relies on informational transparency to accomplish its health insurance reform goals, but certain states have engaged in obstructive federalism by rejecting consumer information provisions while maintaining federal penalties. Vukadin argues that states embracing this approach consign their citizens to second-class ACA status, retaining federal penalties and individual mandate costs while denying residents access to consumer information benefits. The ACA's informational transparency provisions are designed at multiple levels to connect consumers with benefits, enforcement officials with targets, and the public with pricing practice information. States can opt out of many consumer information provisions, but they cannot opt out of federal individual and employer mandates and associated penalties; these provisions apply equally regardless of state recalcitrance. Vukadin contends that while some ACA provisions have federal fallbacks, effective consumer information provision requires state participation and should not be ceded to federal government alone. Citizens in recalcitrant states should advocate for informational transparency and full information dissemination to consumers, similar to state demands for Medicaid expansion.

Topics: Constitutional Law · Federalism · Administrative Law

Keywords: Affordable Care Act · obstructive federalism · consumer information · health insurance exchanges · Medicaid expansion