Implementing health care reform in the United States: Intergovernmental politics and the dilemmas of institutional design

Béland, Daniel; Rocco, Philip; Waddan, Alex

doi:10.1016/j.healthpol.2014.01.010

Cited by 26 publications

(25 citation statements)

References 14 publications

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“…() argue that partisanship explains states' decisions on whether to comply with PPACA requirements by creating state‐based exchanges and expanding Medicaid . Democrats focus on the expansion because their voters consist of a larger percentage of non‐White and lower income individuals who are more likely to benefit from it, whereas Republicans do not prioritize expansion because their voters consist of wealthier White citizens who are less likely to benefit from it (Béland et al., ; Frakt and Carroll, ; Hudak, ). As Republican Governor Bobby Jindal from Louisiana states: “…States must be freed from decades‐old rules that are no longer relevant to 21st‐century healthcare.…”

Section: Theory Hypothesis and Previous Workmentioning

confidence: 99%

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Party Politics, Governors, and Healthcare Expenditures

Joshi

2014

Economics & Politics

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This study examines the impact of gubernatorial partisanship on the growth of healthcare expenditures (HCE) for a panel dataset of 50 U.S. states over the 1991–2009 period. Using the parametric regression discontinuity design, I find no partisan effect on the growth of state's per capita real total personal HCE. However, an analysis of the growth rates of the components of HCE suggests that there is a causal effect of party affiliation on the “prescription drugs” component. These findings are robust to the inclusion of additional covariates in the parametric approach as well to the use of the non‐parametric regression discontinuity approach. The results further suggest that the impact of gubernatorial partisanship does not depend on the length of the governor's term in office.

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Section: Theory Hypothesis and Previous Workmentioning

confidence: 99%

“…States that are not expanding Medicaid are concerned about its cost (Béland et al., ; Jones et al., ). The Congressional Budget Office () projects that states will spend 1.6% more on Medicaid and CHIP because of the PPACA than they would have spent without it.…”

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confidence: 99%

Party Politics, Governors, and Healthcare Expenditures

Joshi

2014

Economics & Politics

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“…While ACA made it illegal for insurance companies to refuse health insurance to those with pre-existing conditions (including LKDs) beginning January 1, 2014,[27] there is the possibility that the ACA – or some of its components – may be repealed in the future. [28] The lack of health insurance at the time of donation also may affect compliance with follow-up for the two years required by UNOS/OPTN and beyond. Consistent with data reported by Schold et al[29], we found that uninsured adults at time of donation were less likely to have 6, 12, and 24 month SCr values reported in the UNOS/OPTN database.…”

Section: Discussionmentioning

confidence: 99%

Health Insurance Trends in United States Living Kidney Donors (2004 to 2015)

Rodrigue

Fleishman

2016

American Journal of Transplantation

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Some transplant programs consider the lack of health insurance as a contraindication to living kidney donation. Still, prior studies have shown that many adults are uninsured at time of donation. We extend the study of donor health insurance status over a longer time period and examine associations between insurance status and relevant sociodemographic and health characteristics. We queried the UNOS/OPTN registry for all living kidney donors (LKDs) between July 2004 and July 2015. Of the 53,724 LKDs with known health insurance status, 8,306 (16%) were uninsured at the time of donation. Younger (18 to 34 years old), male, minority, non-employed, less educated, non-married LKDs and those who were smokers and normotensive were more likely to not have health insurance at the time of donation. Compared to those with no health risk factors (i.e., obesity, smoking, hypertension, eGFR, proteinuria)(14%), LKDs with 1 (18%) or ≥2 (21%) health risk factors at the time of donation were more likely to be uninsured (P<0.0001). Among those with ≥2 health risk factors, blacks (28%) and Hispanics (27%) had higher likelihood of being uninsured compared to whites (19%; P<0.001). Study findings underscore the importance of providing health insurance benefits to all previous and future LKDs.

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“…Although the implementation process would soon give way to a far more temperate policy reality (see e.g., Wei & Jarlenski, ), which, under the current Republican presidential and congressional leadership stands further undoing, the introduction of the ACA represents an extraordinary juncture in American health care history. Interestingly, the most enduring features of the reform so far have been changes in the form of increased federal regulation of the private insurance market (Béland et al., ). These include measures designed to give the federal government (in collaboration with states) the authority to review increases of health insurance premiums by 10 percent or more to ensure that they adequately correspond with changes in the cost of care (Kaiser Family Foundation ).…”

Section: The Assertion Of the Federal Government In The Phi Of The Usmentioning

confidence: 99%

Redefining the State in Health Care Policy in Italy and the United States

Doetter¹,

Neri²

2018

European Policy Analysis

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In highly decentralized political systems such as in Italy and the United States of America (US), the global financial crises beginning in 2008 gave way to a more assertive role of the central government in policy areas including health. In the Italian National Health Service, the central government intensified cost containment, partially recentralizing policy‐making and limiting the autonomy of Regions with high deficits. In the predominantly private health system of the US, crisis ushered in dramatic federal health reform in 2010. This study asks, what role did financial crisis and an analogous intergovernmental context surrounding health care play in explaining the (re)centralization observed between two highly divergent health system types? We examine evidence particularly with a view to the concept of regulatory hybridization (Rothgang et al., 2010) and the larger explanatory model of health care system change put forth by Schmid, Cacace, Götze and Rothgang (2010) and Frisina Doetter, Götze, Schmid, Cacace and Rothgang (2015). In doing so, we explore the relationship between functionalist vs. contextual variables embedded within the model. Our findings highlight the necessity to revise the concept of regulatory hybridization to allow for greater analytical focus on territorial shifts in power to understand developments in decentralized health care systems.

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Implementing health care reform in the United States: Intergovernmental politics and the dilemmas of institutional design

Cited by 26 publications

References 14 publications

Party Politics, Governors, and Healthcare Expenditures

Party Politics, Governors, and Healthcare Expenditures

Health Insurance Trends in United States Living Kidney Donors (2004 to 2015)

Redefining the State in Health Care Policy in Italy and the United States

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