There is an ongoing conflict between the federal government and individual states over benefits and HR policies--with states seeking to fill gaps left by the federal government and the federal government claiming that the state initiatives are preempted.

In my previous post I discussed how the federal role in U.S. healthcare markets is likely to shrink in a post-ACA environment. So, who picks up the slack? It is likely that the largest increases in role/autonomy will go to individual states and insurance companies. This blog post focuses on a potential increase in states’ roles; my next post discusses increased control that may flow to insurance companies. Here’s how this may play out: