“What we’re still seeing with how it plays out in the implementation of health care reform is the greater role states have in implementing reform as a result of the big role they are defined to play in the Affordable Care Act,” said McClellan, the keynote speaker at the American Bar Association’s Health Law Section’s 10th Annual Washington Health Law Summit. “What I think that is going to mean is that in ways we haven’t seen yet, the states are going to have more negotiating leverage.”
McClellan, who now serves as director of the Engelberg Center for Health Care Reform at the Brookings Institution, also said this scenario has started to evolve as states decide whether to accept the federal health care exchanges and how they choose to implement Medicaid reforms.
The Affordable Care Act encourages each state to run its own exchange, which allows individuals and small businesses to purchase health insurance.
Timing will play a vital role in the months ahead now that the Obama administration has released new health care regulations, McClellan said.
“There isn’t much time between now and the fall of 2013, when the exchanges are supposed to be up and running,” he added. “It will be a fast march to the implementation of coverage.”
McClellan said lawyers can help in the process of creating a more productive health system by working to change policy that does not encourage more efficient and effective care.
“They should recognize that this is an incremental process that will lead to fundamental changes, so have the ultimate goal in mind: better care but lower costs,” he said. “However, recognize it will take time to get there.”
The Brookings Institution has issued a series of reports called “Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth.”