Interplay between states and federal government in implementing the ACA

The fierce national debate over health care reform includes deep divisions over the appropriate roles of the federal and state governments. While Senator Sanders calls for expanding Medicare to cover all Americans, the Trump administration pushes for the states to have far greater authority. However, the ACA points towards a more effective inter-governmental partnership, one in which the states have significant policy and administrative discretion, bounded by strong national standards designed to limit unacceptable inequities.