Kofman, who supports the federal law, adds that instead of adding to government bureaucracy, the law has forced streamlining at the state level.
"A lot of coordination has been going on. The planning that it takes to get this right is extensive," she says. "Before in many states people didn't talk to each other, didn't know what each other did and now there are more efficiencies. If capacity to do something exists, it's being leveraged. It's almost government at its best because you are not duplicating or setting up new programs where there's capacity or the skill set to do it already."
Former Maine Gov. John Baldacci, a Democrat who also worked at the Pentagon last year working on reforming the veterans' health insurance system, says the law gives states the opportunity to be "major players" in crafting their own reforms.
"The states are going to end up being more of a major player in the health care reform efforts going forward just by their very nature. You've got the money that's been set aside for innovation and there are organizations working on developing that," he says.
But Baldacci, who led the Pine Tree state from 2003 to 2011, also cautions that more changes to the law should be expected.
"It was such a major effort that as it works out, I think people will begin to see all of the different pieces to it," he says. "There are some people may want to keep, some they may want to amend and some they may want to throw out."
Rebekah Metzler is a political writer for U.S. News & World Report. You can contact her at email@example.com or follow her on Twitter.
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