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Federalism and Health Policy

Author: Alan Weil

Publisher: The Urban Insitute

Published: 2003

Total Pages: 448

ISBN-13: 9780877667162

The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.

Fragmented Democracy

Author: Jamila Michener

Publisher: Cambridge University Press

Published: 2018-03-22

Total Pages:

ISBN-13: 1108245323

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Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.

American Federalism in Practice

Author: Michael Doonan

Publisher: Brookings Institution Press

Published: 2013-08-30

Total Pages: 169

ISBN-13: 0815724837

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American Federalism in Practice is an original and important contribution to our understanding of contemporary health policy. It also illustrates how contentious public policy is debated, formulated, and implemented in today’s overheated political environment. Health care reform is perhaps the most divisive public policy issue facing the United States today. Michael Doonan provides a unique perspective on health policy in explaining how intergovernmental relations shape public policy. He tracks federal-state relations through the creation, formulation, and implementation of three of the most important health policy initiatives since the Great Society: the State Children’s Health Insurance Program (CHIP) and the Health Insurance Portability and Accountability Act (HIPAA), both passed by the U.S. Congress, and the Massachusetts health care reform program as it was developed and implemented under federal government waiver authority. He applies lessons learned from these cases to implementation of the Affordable Care Act. “Health policymaking is entangled in a complex web of shared, overlapping, and/or competing power relationships among different levels of government,” the author notes. Understanding federal-state interactions, the ways in which they vary, and the reasons for such variation is essential to grasping the ultimate impact of federalism on programs and policy. Doonan reveals how federalism can shift as the sausage of public policy is made while providing a new framework for comprehending one of the most polarizing debates of our time.

Health Policy, Federalism, and the American States

Author: Robert F. Rich

Publisher: The Urban Insitute

Published: 1996

Total Pages: 340

ISBN-13: 9780877666608

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In the ongoing struggle between those favoring centralized and those favoring decentralized government, health care policy is an important issue. This book has three goals: (1) to illustrate how theories of federalism and intergovernmental relations can provide a useful framework for examining how to "divide up the job" in the health care area, (2) to assess the capacity of the states to actually implement health care policy changes, and (3) to weigh the merits of alternative visions of the future role of states and the federal government in health care policy.

Comparative Health Care Federalism

Author: Katherine Fierlbeck

Publisher: Routledge

Published: 2016-03-09

Total Pages: 374

ISBN-13: 1317163117

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Examining the changing nature of health care federalism within a competitive global context, Comparative Health Care Federalism provides a rich and nuanced account of the way in which the interplay of federal relationships impact health care within an array of systems. The editors have gathered together some of the leading international health policy scholars to provide detailed accounts of the dynamics of federal health policy-making within their respective jurisdictions. Complementing the theoretical and methodological objectives, this book provides a detailed, empirical description of the challenges faced by different states and the ways in which health policy-making works within the federal, quasi-federal, and functional federal systems presented. In chapters on the United States, Australia, Canada, Germany, Spain, Italy, Austria, the United Kingdom, the EU, India, China, Brazil, and the Russian Federation the authors consider what variables contribute to, and stand in the way of, the formation of robust and sustainable health care systems.

American Federalism in Practice

Author: Michael Doonan

Publisher: Brookings Institution Press

Published: 2013-08-26

Total Pages: 169

ISBN-13: 0815724845

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American Federalism in Practice is an original and important contribution to our understanding of contemporary health policy. It also illustrates how contentious public policy is debated, formulated, and implemented in today's overheated political environment. Health care reform is perhaps the most divisive public policy issue facing the United States today. Michael Doonan provides a unique perspective on health policy in explaining how intergovernmental relations shape public policy. He tracks federal-state relations through the creation, formulation, and implementation of three of the most important health policy initiatives since the Great Society: the State Children's Health Insurance Program (CHIP) and the Health Insurance Portability and Accountability Act (HIPAA), both passed by the U.S. Congress, and the Massachusetts health care reform program as it was developed and implemented under federal government waiver authority. He applies lessons learned from these cases to implementation of the Affordable Care Act. "Health policymaking is entangled in a complex web of shared, overlapping, and/or competing power relationships among different levels of government," the author notes. Understanding federal-state interactions, the ways in which they vary, and the reasons for such variation is essential to grasping the ultimate impact of federalism on programs and policy. Doonan reveals how federalism can shift as the sausage of public policy is made while providing a new framework for comprehending one of the most polarizing debates of our time.

Health Policy and Federalism

Author: Queen's University (Kingston, Ont.). Institute of Intergovernmental Relations

Publisher: IIGR, Queen's University

Published: 2002

Total Pages: 200

ISBN-13: 0889118590

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An examination of whether federal institutions influence policy outcomes in the health sector.

Health Policy, Federalism and the American States

Author: ROBERT F.. WHITE RICH (WILLIAM D.)

Publisher: Routledge

Published: 2020-04-02

Total Pages: 329

ISBN-13: 9781138385856

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First published in 1997, this volume emerged in the ongoing struggle between those favouring centralized and those favouring decentralized government, and has three goals: 1) To illustrate how theories of federalism and intergovernmental relations can provide a useful framework for examining how to 'divide up the job in the health care area'; 2) To assess the capacity of the states to actually implement health care policy changes; 3) To weigh the merits of alternative visions of the future roles of states and the federal government in health care policy.

Medicaid Politics

Author: Frank J. Thompson

Publisher: Georgetown University Press

Published: 2012-09-19

Total Pages: 289

ISBN-13: 1589019350

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Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise. Many astute observers of the Medicaid debate have long claimed that “a program for the poor is a poor program” prone to erosion because it serves a stigmatized, politically weak clientele. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system. In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.