Oregon Health Care Policy
The passage of national health care reform in 2010, known as the Affordable Care Act (ACA), created a number of new mandates for states in order to increase the percentage of Americans with access to health care. My summer work focuses on the state of Oregon and its creation of a state health insurance exchange and coordinated care organizations (CCOs), legislation for which were just passed spring 2011. While the state health insurance exchange was mandated by the ACA, the CCOs actually require waivers from the federal government to change the compensation system for doctors away from fee-for-service. Both developments require public-private partnerships. I plan to investigate if these partnerships can provide a cooperative model as an alternative to the dominant one of competitive social service delivery (that assumes competition provides better outcomes for consumers). The cooperative model requires input, deliberation and concessions across a variety of stakeholders. Understanding the dynamics of those processes--why some succeed and others fail--is critical for any assessment of the programs (how inclusive or democratic are they) but also their likelihood of succeeding in other states.