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vii Acknowledgments This book is the result of more than a decade of exploration of intergovernmental relations and U.S. health care reform at the national and state levels. It has been influenced by my work in Congress, for federal government agencies, and with the states as well as by my academic work at the Heller School for Social Policy and Management at Brandeis University, the Politics Department at Brandeis, and the George Washington University. It is informed by a wide range of practitioners and academics who gave freely of their time, knowledge, and insight. The idea of studying federalism across the policy process came from discussions with and reviews by Jeff Prottas, Deborah Stone, and John McDonough, and this study has been influenced by the thinking of each of these individuals . My understanding of the historical roots of federalism within the broader institutional framework benefited from the guidance of Sid Milkis; notions of the trade-off between accountability and reliability came from a course that I took with Shep Melnick. The theories of federalism that underpin this work are based on seminal studies by Daniel Elazar, Samuel Beer, Martha Derthick, Timothy Conlan, Paul Peterson, and many others. Insight into Massachusetts reform came from Phil Johnston and Sarah Iselin and from the work on Massachusetts health care reform by the Blue Cross Blue Shield of Massachusetts Foundation. The wisdom and mentorship of Stuart Altman has enriched this study and kept me on track. David Shactman provided critical insight and support on many of the chapters. Brian Rosman reviewed the Massachusetts chapter in detail, and James Morone and Dan Ehlke reviewed a chapter on Massachusetts reform that they included in their commendable textbook, Health Politics and Policy. Much of the data and information on the cases came from senior congressional staff on both sides of the aisle; White House officials; senior state officials ; representatives of state organizations such as the National Governors Association, the National Conference of State Legislatures, and the National Association of Insurance Commissions; and public interest groups such as the Children’s Defense Fund, Child Welfare League, Health Care for All of Massachusetts, and others. Many are cited; others provided politically sensitive information not for direct attribution. The intellect, dedication, and tireless efforts of these officials eviscerate stereotypes of disengaged “bureaucrats ” and reinforce the notion of honorable public service. Lisa Lynch, the dean of the Heller School, provided support, advice, and sabbatical coverage, all of which were essential to this work and are much appreciated. Research support and editing were provided by Jaclyn Rappaport , Nicole Hudson, Kate Tull, Susan Houghton, Erin Doonan, and Chris Woolston. Every day I am energized by my students in the Master’s of Public Policy Program at the Heller School and bolstered by colleagues Janet Bogaslaw , Norma DeMattos, Mary Brolin, Corinne Kyriacou, Shelly Steenrod, and Sarah Rudy. Special thanks to Chris Kelaher from the Brookings Institution Press for his confidence in this project, guidance, and professionalism. Brookings Press editor Eileen Hughes made significant contributions that pushed the book over the finish line. The book is dedicated to my parents, J. Peter and Dolores Doonan, whose encouragement and support know no bounds and whose multiple reviews added clarity. My partner Patty and daughters Samantha and Chloe make it all worthwhile. viii / acknowledgments ...

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