and mrs. clinton. if you use it, everybody will know that i was the source. and ways ve i was very worried about that. but i trusted them. sunday night on q and a. real j care experts recently outlined how the affordable care act works in their state. the brookings institute in washington hosted the two-hour discussion on the health care law s successes and failures. good morning and thank you for coming. welcome to this session is can which is a joint session of the brooking s institution and the rockefeller institute of government. and we re going to talk about the results after five-state study on how competition is working in the affordable care act marketplaces. and what we might learn from this study and how we think about competition in the marketplaces going forward and to officially open us up. i welcome my colleague richard nathan from the rockefeller institute to the platform. thank you, alice. i don t work at brookings so maybe i shouldn t welcome people.
good morning and thank you for coming. welcome to this session which is a joint session of the brookings institution and the rockefeller institute of government. we re going to talk about the results of a five-state study on how competition is working in the affordable care act marketplaces and what we might learn from this study and how we think about competition in the marketplaces going forward. and to officially open us up, i welcome my colleague, richard nathan, from the rockefeller institute, to the platform. thank you, alice. i don t work at brookings so maybe i shouldn t welcome people, but i worked here 11 years. it is a while ago. and this is one of my favorite places to it be able to work with colleagues. it is a pleasure today to welcome you to this conference, as alice said. the brookings and rock fefeller institute field network study of the competitive she mentioned this competitiveness of marketplaces in health insurance, individual, non-group health ins
charities.rivate he said his family had used those when his fighting unsuccessfully against cancer. questioned by n reporters, said they had used he medically needed provision of the medicaid law. denied ker initially this, said his father was wrong. his father suggested that he was right. but peaker admitted this continued to oppose expansion of medicaid. i suspect that this opposition will continue. a little more muted now than it had been earlier for a political reasons. one, they are now close to one enrolled in the healthcare exchange. two, some groups have come support the expansion of medicaid like florida medical in the ion that had not past. thirdly, probably most a big ntly, there was election coming up in florida the likely democratic candidate whom some of you may republican e the governor of florida, is now aggressively pushing the care act and the urrent governor is not responding as aggressively as he i suspect because of these other changes. one other chan
and i think it needs really deeper thinking on what it takes to do that. but if countries like egypt or emirates are on board, great. we have seen a lot of volunteers wanting to cross the border and the iranen government has stopped ian government has stopped them. what happened to yazidis really filled every sentiment. but iran would not allow them to come so easily and the kurds seem in iran are not in this picture that people are talking about. but this is a challenge. i think, again, iran will be well advised to have their own strategy to deal with them. but in terms of them crossing the board to help unless they do it illegally, there s no other way that they can. okay. yes. you talked about strategy of aircraft supporting someone on the ground. so do you see the kurds doing this not only in the kurdish regions but into regions even reaching to mosul or do you think kurds will not take this step? the kurds will stop short of going into any traditional sunni areas.
demographics, another factor influences state responses to a.c.a. just as the issue of medicaid expansion reflect issues. state experiences also tell us there is more to the equags than just politics. what is notable in our field research is how market and demographic forces have shaped state level deliberations and action. when the a.c.a. was signed into law, a number of states signaled their intonet create their own state operated exchanges. it is safe to say that the conventional wisdom held that the federal exchange would be a fallback rather than a default choice and the states would actively pursue exchanges. we know this has not come to pass. as our field research con firms, much of this was for partisan reasons. there were other factors at stake that proved to be a real world test for this new policy design. for some states like west virginia which was one of the first states to authorize planning, analysis and the challenges of developing an i.t. system suggested tha