U-Turn: America’s Return to State Healthcare Solutions


Paperback ISBN: 978-0985208639

Price: $9.95

“The federal Affordable Care Act was designed in the image of a state law that was crafted to address the challenges of Massachusetts, which from a healthcare perspective has some unique demographics, care preferences, marketplace, and world-class medical institutions. After an ill-advised headlong rush to redesign one-sixth of the U.S. economy, the country has an opportunity to encourage the states to design reforms that meet their specific needs, and enable a real marketplace for healthcare to develop.”

– Jim Stergios, Executive Director of Pioneer Institute 

Share this on Twitter

#UTurn #hcr

Get Updates On Our Healthcare Research and Events!

With Congress and the Trump Administration poised to repeal the Affordable Care Act, many observers are asking what the replacement plan looks like.  A new book, U-Turn: America’s Return to State Healthcare Solutions, proposes that the states take the lead in healthcare reform, as Massachusetts did in 2006, and that Washington facilitate the transition, rather than try to dictate every move.

2017. The year in which America takes a U-Turn on health care policy. The new Congress and president promise to repeal and replace the Patient Protection and Affordable Care Act. How will they do it? And after reversing course, what direction will health care take? In articulating answers, U-Turn does not avoid the hard questions. What are workable solutions that offer the needed flexibility and respect our federalist government structure? What solutions meet key challenges: the runaway cost of care, questions about quality of care, access to medical services for all residents, and the consensus that has emerged today to ensure coverage for those with pre-existing conditions? How can the United States grapple with exploding Medicaid and Medicare costs?

U-Turn is an updated and abridged version of The Great Experiment, published in 2012. Praise for The Great Experiment:

“The Great Experiment persuasively lays out a state-based perspective on healthcare reform, and is an honest, vital policy contribution for how the federal government can work productively with states to get our fiscal house in order. One can only hope the message penetrates Washington.”

– Douglas Holtz-Eakin, former director of the Congressional Budget Office

Regardless of the fate of the ACA, authors Tom Miller and Jim Capretta of the American Enterprise Institute write that the states will need to move ahead. They propose a combined federal-state effort called “competitive federalism” to encourage flexibility and unique approaches, the most successful of which could be adapted and improved by other states.

“If each level of government plays its proper role, reforms can keep rates of coverage and quality of care high, while reining in cost increases,” Pioneer Institute’s Senior Fellow in Healthcare Joshua Archambault added. “Until Washington, D.C. recognizes that New Mexico is not the same as New Hampshire when it comes to healthcare, we will not achieve the systems that best serve patients.”