Factors influencing the implementation of health care reform: an examination of the Concurrent Care for Children provision.

In the wake of the 2013 Presidential reelection, states now face the reality of implementing the healthcare reform, including ACA section 2302 (Concurrent Care for Children). The purpose of our study was to examine the influence of economic, political, and legal factors on state implementation of ACA 2302. Using data from 2010 to 2012, our analysis revealed that for early implementers economic, political or legal factors did not influence implementation of ACA 2302. In 2011, states that were engaged in Medicaid cost containment efforts were more likely to implement ACA 2302 and in 2012, states experiencing a budgetary crisis were less likely to implement ACA 2302. Our findings suggest that state-level implementation of ACA 2302 may be an important bellwether for future healthcare reform implementations.