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The Political Economy of State Medicaid Policy

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  • Barrilleaux, Charles J.
  • Miller, Mark E.

Abstract

We develop and test a market-based model to explain variations in states' welfare medicine policy decisions. The empirical results support the model of state policy outputs, indicating that states' spending efforts for welfare medicine are most sensitive to the supply of services within their borders. We learn in addition that spending effort declines with demand for services, indicating that the states spending the highest proportions of total personal income for the program are those who need it most and can afford it least. Measures of political system development affect spending effort positively and significantly, suggesting that ideology, diversity of interests, and administrative professionalism increase states' welfare efforts.

Suggested Citation

  • Barrilleaux, Charles J. & Miller, Mark E., 1988. "The Political Economy of State Medicaid Policy," American Political Science Review, Cambridge University Press, vol. 82(4), pages 1089-1107, December.
    • Handle: RePEc:cup:apsrev:v:82:y:1988:i:04:p:1089-1107_19
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    Cited by:

    1. Goldhaber-Fiebert, Jeremy D. & Babiarz, Kimberly S. & Garfield, Rachel L. & Wulczyn, Fred & Landsverk, John & Horwitz, Sarah M., 2014. "Explaining variations in state foster care maintenance rates and the implications for implementing new evidence-based programs," Children and Youth Services Review, Elsevier, vol. 39(C), pages 183-206.
    2. Douglas D. Roscoe, 2014. "Yes, Raise My Taxes: Property Tax Cap Override Elections," Social Science Quarterly, Southwestern Social Science Association, vol. 95(1), pages 145-164, March.
    3. Edward Alan Miller, 2005. "State health policy making determinants, theory, and methods: A synthesis," Social Science & Medicine, Elsevier, vol. 61(12), pages 2639-2657, December.
    4. Gustavo Leal Fernandez, 1991. "Sozialversicherungssysteme jenseits der Industriestaaten," Wirtschaft und Gesellschaft - WuG, Kammer für Arbeiter und Angestellte für Wien, Abteilung Wirtschaftswissenschaft und Statistik, vol. 17(1), pages 85-94.
    5. Gustavo Leal Fernandez, 1991. "Sozialversicherungssysteme jenseits der Industriestaaten. Ein Rahmen für die Sozialpolitik in den neunziger Jahren (Berichte und Dokumente)," Wirtschaft und Gesellschaft - WuG, Kammer für Arbeiter und Angestellte für Wien, Abteilung Wirtschaftswissenschaft und Statistik, vol. 17(1), pages 85-94.
    6. Peter T. Leeson & Henry A. Thompson, 2023. "Public choice and public health," Public Choice, Springer, vol. 195(1), pages 5-41, April.
    7. Russell S. Sobel, 2014. "The elephant in the room: why some states are refusing to expand Medicaid," Applied Economics Letters, Taylor & Francis Journals, vol. 21(17), pages 1226-1229, November.
    8. Dorothy M. Daley & Megan Mullin & Meghan E. Rubado, 2014. "State Agency Discretion in a Delegated Federal Program: Evidence from Drinking Water Investment," Publius: The Journal of Federalism, CSF Associates Inc., vol. 44(4), pages 564-586.

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