Contents:
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Email alerts Latest Issue. Subscribe to Article Alert. Why have Republican governors spurned this incredibly good deal?
Their ostensible justification has been disbelief that the federal government would hold up its end of the bargain, leaving states to pick up the tab. But researchers at the Urban Institute threw cold water on this argument in a study last month. They found that the federal government has almost never reduced funding to the states for Medicaid.
In fact, it has not done so since , when President Reagan and Congress imposed a temporary funding cut.
Indeed, Congress has been far more likely to increase funding for state Medicaid programs. It has done so twice in recent memory — in and in — boosting state funding even while making other cuts to the program. The sanctity of the federal commitment to Medicaid has only grown in recent years.
As evidence of federal faint-heartedness, conservatives point to an administration proposal floated during budget negotiations that would have reduced federal Medicaid funding to the states. For more information on our use of cookies, please review our cookie policy. As their arguments are rendered hollow, obstructionist Republicans are paying the electoral price for thwarting these types of programs. 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. Indeed, Congress has been far more likely to increase funding for state Medicaid programs. Lots of good information and history of Medicaidbut the polemics are a significant distraction.
As evidence of federal faint-heartedness, conservatives point to an administration proposal floated during budget negotiations that would have reduced federal Medicaid funding to the states. But this bad idea was dropped after the states got newfound bargaining power from the Supreme Court's decision making the Medicaid expansion entirely voluntary.
With the expansion now optional, the administration can ill afford to weaken the financial carrot for red states to buy in. This has also made the administration agreeable to some conservative twists on traditional Medicaid, like using public dollars to enroll people in private health plans in Arkansas and Iowa.
The Urban Institute also quantified how much intransigent red states are losing by resisting ObamaCare. He is a fellow of the National Academy of Public Administration and has published extensively on matters of health policy. Boychuk, Karen Mossberger, and Mark C.
Rom, Series Editors Reviews "The book provides an excellent analysis of the Medicaid program, while strengthening understanding of the broader questions regarding how the policy process works. This volume represents a major contribution to the literature on state health policy-making, and Medicaid policy in particular, but it is also ideally suited for use in both graduate and advanced undergraduate courses in health policy, federalism, and public policy.
Thompson's scholarship is first rate, and his discussion of democratic governance, accountability, and program durability brings a fresh new perspective to the study of state Medicaid reform. In doing so, he provides readers with a way to understand not only the evolution of Medicaid policy, but the political significance of federalism for health care reform.
Hackey , professor and director, Health Policy and Management Program, Providence College "One of the most remarkable developments in the American welfare state over the past half century has been the stunning growth of Medicaid. Once dismissed as Medicare's poor cousin, Medicaid today stands as a key pillar of the US health insurance regime.
The expansion of Medicaid was at the center of President Obama's health care reform, and the program is increasingly viewed as a bridge to universal coverage. In Medicaid Politics , political scientist Frank Thompson explains how Medicaid works, why the program has grown, and what forces have shaped both its durability and vulnerability.
Timely, thoughtful, and thoroughly researched, this well-written book will inform anyone interested in health policy.