Issue Description


The Patient Protection and Affordable Care Act has been the topic of heated political debate since becoming the law of the land almost one year ago. As right-wing calls for repeal continue to make headlines, many positive and popular provisions of the law are already benefiting families across the nation. Working-class and middle- class families have seen their health security increased by provisions that rein in insurance industry abuses and expand coverage, making it less likely that they will lose their savings due to an illness or injury, or be unable to afford needed treatments.

But as the curtain draws on the first year of the life of the Affordable Care Act, what happens in the second year at the state level may prove to be even more critical to its ultimate fate.

In 2011, the shape of the most prominent piece of the law -- and the health security and economic security of American families for decades to come -- will be decided in statehouses across the nation. This legislative session, states have a once-in-a-generation opportunity to put consumer protections and stronger access to affordable health care coverage in the hands of their residents.

Under the health law enacted in March 2010, states are tasked with setting up health care "exchanges," or marketplaces that will create new incentives for the health insurance industry to deliver quality care at lower prices. Exchanges will require insurance companies to spend more of consumers’ premium dollars on actually providing health care -- instead of bloated administrative overhead and egregious compensation for CEOs.

As part of our 2011 Blueprint for Economic Security, Progressive States Network has compiled an overview of how to Enact a Progressive State Exchange this session, including a focus on key legislative elements of a strong exchange such as determining the Governance of the health exchange and creating a Board Structure that will ensure a strong governing body, as well as a set of Next Steps for creating a strong exchange.

Under the timeline set out in the Affordable Care Act, state exchanges are scheduled to begin operating in 2014 -- but every state legislature must act this session to pass a strong version of an exchange in their state if they do not want the federal government to run their exchange. By implementing a strong exchange, states can allow the uninsured, self-employed and small businesses to shop for insurance in a competitive marketplace, giving consumers greater control and power through information and choice.


ACA Timeline

This link to's time line for the Affordable Care Act provides an interactive tool to show and explain what provisions take effect and when.  It outlines a comprehensive analysis of the federal law.

2010 Shared Multi-Stated Agenda: Corporate Transparency in State Budgets

As states increasingly enact budget disclosure rules - "google government" as
some have deemed it — states should enact policies to address the missing piece of disclosure, namely
requiring full public information about how corporate interests that benefit from government contracts,
economic subsidies and tax breaks are actually spending the money received.     Government contractors
and subsidy recipients should disclose the number of people employed, their location, hours worked and
wages paid on each contract, total contracts and subsidies received by each company, and a continuing
accounting of the costs of both contract cost overruns and subsidy payments.   Large businesses should
reveal their total revenue generated in the percentage of that revenue paid in state corporate income taxes.


We live in a global economy where corporations have little loyalty to maintaining decent paying jobs in the United States. Failed policies of corporate welfare and tax subsidies to the already wealthy do little but accelerate job flight and growing economic inequality.

Promoting a growing economy requires a combination of key policies, including:


The public administration of elections is the fundamental basis for the freedom and fairness of our elections.  Without government control of elections and public scrutiny of the process, establishing the legitimacy of election results is not possible.  Publicly administered elections were until recently an unchallenged aspect of our democracy.  However, the move to computer systems to administer elections and the swift, federally-funded adoption of these systems has led to a privatization of many election functions.

Electronic voting machines are the most visible aspect of our voting systems that has been privatized.  Machine vendors insist on maintaining the privacy of both the hardware and software that they are selling or renting to states.  This is extremely dangerous to the security of our elections.  Without having access to the "guts" of the machines, there is no way to analyze machine errors or to determine how secure the machines are.  These private voting systems have caused serious problems.

Florida's 18,000 Missing Votes: In the case we mentioned earlier from Sarasota, Florida, both the loser of the race and a group of voters brought separate lawsuits seeking access to the voting machines and the software responsible for the 18,000 lost votes.  Both were denied access based on a claim by the Election Systems and Software Company that the machines and their software are trade secrets.  The court upheld the privacy rights of the corporation over the right of the people to a fair election.

New Jersey Voters Battle Sequoia: During this year's presidential primary, machines in 37 New Jersey counties recorded vote totals that did not match with summary tapes of the votes cast.  When county clerks tried to have a Princeton University computer scientist examine the machines, both the clerks and the professor were threatened with a lawsuit by the machine manufacturer.  In the face of a lawsuit the clerks dropped their efforts to have the machines examined.  A group of government reform advocates then filed a lawsuit to have the machines declared unreliable, and as a result of that lawsuit a judge has ordered that the machines be examined by independent computer professionals.

While the report based on that examination is forthcoming, another computer scientist purchased some of the machines through a government auction and has determined that they can easily be hacked.

Other parts of the election system have also been privatized in some states, including statewide voter registration databases and the poll books that contain the list of eligible voters.  In two instances from this past presidential primary, Georgia had numerous reports by voters that electronic poll books, made by Premier Election Solutions, were crashing and inoperable, leading to long lines and citizens leaving polling sites without casting ballots; in the New Mexico Democratic presidential caucus, a flawed voter registration database prepared for the state by the Elections Systems & Software Company led to thousands of voters' names not appearing on the voting rolls.

Principles of Public ElectionsVoter Action is the lead organization responding to the increasing privatization of our election systems.  In addition to paper ballots and post-election audits, they have identified the following as essential aspects of keeping public control over elections:

  • Open-source voting systems.  Even with voter-marked paper ballots, citizens must know that their right to vote overrides any alleged trade secret of a private corporation. When votes are counted in secret by private companies, the integrity of the process suffers.  All voting systems in the United States should be required to adhere to open-source standards.
  • Public oversight.  Public control of our elections is dependent upon an active, engaged citizenry monitoring the electoral process.  Grassroots networks across the country have already helped to expose key voting-rights barriers that threaten the integrity of our elections.  With even greater sunlight, we can help ensure that our elections are open, transparent, free, and fair.

Given the broader scandals in privatization of public services, it makes no sense to entrust our most fundamental right to vote to private companies that hide behind "trade secrets" and other corporate laws to escape accountability.



Families need help. That's the message that every parent will tell you, as costs strain family budgets. That includes both financial help and respect for the diversity of families in our nation, including policies to support:


Progressive States is committed to a society where all are equal under the law and where government and economic institutions are accountable to the public, including:

  • Media Reform should expand the diversity of voices involved in our public debatein place of the corporate control of much of current media.


Just as corporate lobbying corrupts the legislative process, the scramble for government contracts corrupts the executive branch and its agencies.  Ohio has seen multiple pay-to-play scandals in recent years where campaign contributors illicitly received unbid special counsel work from the attorney general's office, no-bid contracts from the secretary of state's office, and control of workers’ compensation investments in the notorious Coingate scandal.  Similar scandals have enveloped public officials in New York, California, South Carolina, Illinois and other states across the country.

A number of states have taken action to assure greater accountability in the public contracting system through common-sense solutions:

Campaign Contributions by Contractors:  Seven states currently have some form of pay-to-play contracting law to bar companies bidding on contracts from making campaign contributions to government officials, and in 2005, New Jersey passed the nation’s most far-reaching pay-to-play law in the wake of local contracting scandals.

Tightening Contracting Standards:  The tighter the standards for the bidding processes and the work done, the less likely incompetent or corrupt companies can buy contracts with campaign contributions.   

Public Citizen — Pay to Play and State Governments
Public Citizen — State Pay to Play Laws
AFSCME — Legislative Approaches to Responsible Contracting
New Jersey Pay to Play Law


As an alternative to raising large sums of campaign cash to fund increasingly expensive campaigns, states can create a publicly-funded clean elections system for candidates who choose to forgo private donations. Strong arguments are available to progressives pursuing this reform. Publicly-funded elections free elected officials from the constant need to fundraise, and allow them to focus on public service, while reducing the ability of private donors to buy influence with officeholders.  Public financing also encourages new people without independent wealth to pursue elected office, increases competition by reducing the disparity in spending between candidates, and reduces the cost of campaigns as candidates accept voluntary spending limits.


Currently one in forty-one Americans have lost their voting rights because of a criminal conviction.  That is over 5 million people who are denied the right to vote.  Of those, over 2 million have completed their sentence of imprisonment, parole, or probation.  These statistics are even more staggering in an international perspective. While the US has only 5% of the world's population, it has almost 50% of those who are prevented from voting by a criminal conviction.  This is the product both of our broad disenfranchisement rules and our exploded criminal justice system.  The racial and ethnic inequity of felon disenfranchisement is striking.  One in eight black men are disenfranchised by these laws, a rate seven times the national average.  In some states it is one in four.

Over 60% of Americans support restoring the right to vote after release from prison, and a similar number think that the right to vote is an important factor in a person's successful reintegration after prison.  This view is shared by several law enforcement organizations.  The American Correctional Association, made up largely of professionals in the criminal justice field, has passed a resolution stating that restoring voting rights is critical to reintegration of ex-prisoners into public life: “[D]isenfranchisement laws work against the successful reentry of offenders as responsible, productive citizens into the community.”

The Sentencing Project — Felony Disenfranchisement
Brennan Center for Justice — Voting After Criminal Conviction
ACLU — Felon Enfranchisement
Christopher Uggen and Jeff Manza — Locked Out: Felon Disenfranchisement and American Democracy