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The Politics of Need: Examining Governors' Decisions to Oppose the “Obamacare” Medicaid Expansion

Published online by Cambridge University Press:  25 January 2021

Charles Barrilleaux  and
Carlisle Rainey
Charles Barrilleaux*
Affiliation:
Florida State University, Tallahassee, FL, USA
Carlisle Rainey
Affiliation:
University at Buffalo, Buffalo, NY, USA
*
Charles Barrilleaux, Florida State University, P.O. Box 323062230, Tallahassee, FL 32306-2230, USA. Email: [email protected]
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Abstract

This article explains governors' decisions to support or oppose Medicaid expansions offered under the 2010 Patient Protection and Affordable Care Act. We theorize that governors' decisions to oppose the funding should depend on both political demands and the level of need in the state, though politics and need are often in tension. We find that governors' partisanship and the composition of the legislature have substantively meaningful effects on governors' decisions, but the level of need in the state exerts little effect on governors' decisions. This suggests that for high profile, highly politicized issues such as the Affordable Care Act, political considerations outweigh the needs of citizens and state economic conditions in gubernatorial decision making.

Keywords

health policypublic policygovernorsexecutive politicslegislative/executive interactionlegislative politicsfederal/statefederalismBayesian statisticsquantitative methodsmethodology
Type
Research Article
Information
State Politics & Policy Quarterly , Volume 14 , Issue 4 , December 2014 , pp. 437 - 460
Copyright
Copyright © The Author(s) 2014

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References

Altman, Drew, and Beatrice, Dennis F.. 1990. “Perspectives on the Medicaid Program.” Health Care Financing Review/1990 Annual Supplement, December 3. http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/Downloads/CMS1191113dl.pdfGoogle Scholar
Alvarez, Lizette. 2013. “In Reversal, Florida to take Health Law Expansion.” New York Times, February 20. http://www.nytimes.com/2013/02/21/us/in-reversal-florida-says-it-will-expand-medicaid-program.htmlGoogle Scholar
Baicker, Katherine, Sarah Taubman, Heidi Allen, Mira Bernstein, Jonathan Gruber, Joseph P. Newhouse, Eric Schneider, Bill Wright, Alan Zaslavsky, Amy Finkelstein, and the Oregon Health Study Group. 2013. “The Oregon Experiment—Effects of Medicaid on Clinical Outcomes.” New England Journal of Medicine 368 (18): 1713–22..Google Scholar
Balz, Dan, and Branigin, William. 2010. “After Midterm Wins, GOP Vows to Block Obama's Agenda.” Washington Post, November 3. http://www.washingtonpost.com/wp-dyn/content/article/2010/11/02/AR2010110207506.htmlGoogle Scholar
Barrilleaux, Charles J., and Miller, Mark E.. 1988. “The Political Economy of Medicaid.” American Political Science Review 82(4): 1089–1108.CrossRefGoogle Scholar
Barrilleaux, Charles, and Berkman, Michael B.. 2003. “Do Governors Matter? Budget Rules and Politics of State Policymaking.” Political Research Quarterly 56 (4): 409–17..CrossRefGoogle Scholar
Barrilleaux, Charles, and Brace, Paul. 2007. “Notes from the Laboratories of Democracy: State Government Enactments of Market- and State-Based Health Insurance Reforms in the 1990s.” Journal of Health Politics, Policy and Law 32 (4): 655–83..CrossRefGoogle ScholarPubMed
Bell, Mark, and Miller, Nicholas. 2013. “Questioning the Effect of Nuclear Weapons on Conflict.” Journal of Conflict Resolution. Published electronically December 2013. http://jcr.sagepub.com/content/early/2013/12/06/0022002713499718Google Scholar
Bernick, Ethan M., and Myers, Nathan. 2008. “Treatment or Placebo: Are State Programs Decreasing the Proportion of Uninsured?” Policy Studies Journal 36 (3): 367–84..CrossRefGoogle Scholar
Berry, William D., DeMeritt, Jaqueline H. R., and Esarey, Justin. 2010. “Testing for Interaction in Binary Logit and Probit Models.” American Journal of Political Science 54 (1): 248–66..CrossRefGoogle Scholar
Berry, William D., DeMeritt, Jaqueline H. R., and Esarey, Justin. 2014. “Bias and Overconfidence in Parametric Models of Interactive Processes.” American Journal of Political Science 54 (1): 248–66..Google Scholar
Biau, Gerard, Devroye, Luc, and Lugosi, Gabor. 2008. “Consistency of Random Forests and Other Averaging Classifiers.” The Journal of Machine Learning Research 9:2015–33.Google Scholar
Brace, Paul R. 1993. State Government and Economic Performance. Baltimore: Johns Hopkins.Google Scholar
Brady, David W., Fiorina, Morris P., and Wilkins, Arjun S.. 2011. “The 2010 Elections: Why Did Political Science Forecasts Go Awry?” Political Science & Politics 44 (2): 247–50..CrossRefGoogle Scholar
Breiman, Leo. 2001. “Random Forests.” Machine Learning 45 (1): 5–32..CrossRefGoogle Scholar
Brown, Lawrence D., and Sparer, Michael S.. 2003. “Poor Program's Progress: The Unanticipated Politics of Medicaid Policy.” Health Affairs 22 (1): 33–44..CrossRefGoogle ScholarPubMed
Campbell, James E. 2010. “The Midterm Landslide of 2010: A Triple Wave Election.” The Forum 8 (4): Article 3. http://www.bepress.com/forum/vol8/iss4/art3Google Scholar
Casella, George, and Berger, Roger L.. 2002. Statistical Inference. 2nd ed. Belmont: Duxbury Press.Google Scholar
Cho, Chung-Lae, and Wright, Deil S.. 2007. “Perceptions of Federal Aid Impacts on State Agencies: Patterns, Trends and Variations across the 20th Century.” Publius 37 (1): 103–30..Google Scholar
Coburn, Tom, and Jindal, Bobby. 2013. “Fix Medicaid, Don't Expand It.” Real Clear Policy, June. http://www.realclearpolicy.com/articles/2013/06/21/fix_medicaid_dont_expand_it_541.htmlGoogle Scholar
Efron, Bradley. 1979. “Bootstrap Methods: Another Look at the Jackknife.” The Annals of Statistics 7:1–26.CrossRefGoogle Scholar
Firth, David. 1993. “Bias Reduction of Maximum Likelihood Estimates.” Biometrika 80 (1): 27–38..CrossRefGoogle Scholar
Gelman, Andrew. 2008. “Scaling Regression Inputs by Dividing by Two Standard Deviations.” Statistics in Medicine 27 (15): 2865–73..CrossRefGoogle ScholarPubMed
Gelman, Andrew, Jakulin, Aleks, Pittau, Maria Grazia, and Su, Yu-Sung. 2008. “A Weakly Informative Default Prior distribution for Logistic and Other Regression Models.” The Annals of Applied Statistics 2 (4): 1360–83..CrossRefGoogle Scholar
Grogan, Colleen, and Rigby, Elizabeth. 2009. “Federalism, Partisan Politics, and Shifting Support for State Flexibility: The Case of the U.S. State Children's Health Insurance Program.” Publius 39 (1): 47–69..CrossRefGoogle Scholar
Hanson, Russell L. 2008. “Intergovernmental Relations.” In Politics in the American States, eds. Gray, V., and Hanson, R.. 8th ed. Washington, DC: CQ Press, 30–60.Google Scholar
Hill, Daniel W. Jr., and Jones, Zachary M.. 2014. “An Empirical Evaluation of Explanations for State Repression.” American Political Science Review 108:661–87.CrossRefGoogle Scholar
Holahan, John F., and Cohen, Joel W.. 1986. Medicaid: The Tradeoff between Cost Containment and Access to Care. Washington, DC: The Urban Institute.Google Scholar
Kail, Ben, Quadagno, Jill, and Dixon, Marc. 2009. “Can States Lead the Way to Universal Coverage? The Effect of Health Care Reform on the Uninsured.” Social Science Quarterly 90:1–20.CrossRefGoogle Scholar
Kaiser Family Foundation. 2012. “A Guide to the Supreme Court's Affordable Care Act Decision.” Focus on Health Reform. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8332.pdfGoogle Scholar
Kaiser Family Foundation. 2014. “Status of State Action on the Medicaid Expansion Decision.” http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/Google Scholar
King, Gary, Tomz, Michael, and Wittenberg, Jason. 2000. “Making the Most of Statistical Analyses: Improving Interpretation and Presentation.” American Journal of Political Science 44 (2): 341–55..CrossRefGoogle Scholar
Klein, Philip. 2013. “Medicaid-Expanding GOP Governors Have Egg on their Faces.” Washington Examiner, May 8. washingtonexaminer.com/philip-klein-medicaid-expand-ing-governors-have-egg-on-their-faces/article/2529192Google Scholar
Kousser, Thad. 2002. “Politics, Economics, and State Policy: Discretionary Medicaid Spending, 1980-1993.” Journal of Health Politics, Policy and Law 27:639–71.CrossRefGoogle ScholarPubMed
Kusnetz, N. 2013. Obamacare's Hidden Battle: Insurance Agents Push State Regulation of Guides to New Marketplaces. Center for Public Integrity, August 9. http://www.publicintegrity.org/2013/08/09/13144/obamacares-hidden-battle-insurance-agents-push-state-regulation-guides-new
Lax, Jeffrey R., and Phillips, Justin H.. 2009. “How Should We Estimate Public Opinion in the States?” American Journal of Political Science 53:107–21.CrossRefGoogle Scholar
Lewin Group. 2013. Managing the Medicaid Enrollment Bump. Washington, DC: Lewin. http://www.lewin.com/~/media/Lewin/Site_Sections/Publications/OptumInsight_LewinGroup_Mging_Medicaid_Surge_WP_6-13-11.pdfGoogle Scholar
Lewis, Daniel C., Schneider, Saundra, and Jacoby, William. 2013. “Governors or Legislators: Who Determines the Spending Priorities of State Governments?” Presented at the 13th State Politics and Policy Meeting, Iowa City, May.Google Scholar
Miller, Vic. 2011. An Overview of Changes in the Federal Medical Assistance Percentages (FMAPs) for Medicaid. Washington, DC: Kaiser Family Foundation, Commission on Medicaid and the Uninsured. http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8210.pdfGoogle Scholar
National Association of State Budget Officers. 2014. State Expenditure Report. Washington, DC: National Association of State Budget Officers. http://www.nasbo.org/publications-data/state-expenditure-reportGoogle Scholar
Nicholson-Crotty, Sean. 2012. “Leaving Money on the Table: Learning form Recent Refusals of Federal Grants in the American States.” Publius 42:449–60.CrossRefGoogle Scholar
Pear, Robert, and David Goodman, J.. 2009. “Governors' Fight over Stimulus May Define G.O.P.” The New York Times. February 22. www.nytimes.com/2009/02/23/us/politics/23governors.html?pagewanted=all&;_r=0Google Scholar
Plotnick, Robert, and Winters, Richard F.. 1985. “A Politico-economic Theory of Income Redistribution.” American Political Science Review 79:458–73.CrossRefGoogle Scholar
Rainey, Carlisle. 2014a. “Arguing for a Negligible Effect.” American Journal of Political Science 58:1083–91.CrossRefGoogle Scholar
Rainey, Carlisle. 2014b. “Compression and Conditional Effects.” Working paper. http://crain.co/compressGoogle Scholar
Rigby, Elizabeth. 2012. “State Resistance to ‘Obamacare.‘” The Forum 10:2. doi:10.1515/1540-8884.1501.CrossRefGoogle Scholar
Rosenbaum, Sara, and Westmoreland, Timothy M.. 2012. “The Supreme Court's Surprising Decision on the Medicaid Expansion: How Will the Federal Government and States Proceed?” Health Affairs 31 (8): 1663–72..CrossRefGoogle Scholar
Singer, Alyne. 2013. “Ten Myths about the Obamacare Medicaid Expansion.” Heritage Foundation Foundry blog. http://blog.heritage.org/2013/04/24/10-myths-about-the-obamacare-medicaid-expansion/Google Scholar
Soss, Joe, Schram, Sanford F., Vartanian, Thomas P., and O'Brien, Erin. 2001. “Setting the Terms of Relief: Explaining State Policy Choices in the Devolution.” American Journal of Political Science 45 (2): 378–95..CrossRefGoogle Scholar
Strobl, Carolin, Boulesteix, Anne-Laure, Zeileis, Achim, and Hothorn, Torsten. 2007. “Bias in Random Forest Variable Importance Measures: Illustrations, Sources, and a Solution.” BMC Bioinformatics 8 (1): 25.CrossRefGoogle ScholarPubMed
Stuber, Jennifer, and Bradley, Elizabeth. 2005. “Barriers to Medicaid Enrollment: Who is at Risk?” American Journal of Public Health 95 (2): 292–98..CrossRefGoogle ScholarPubMed
Tausanovitch, Chris, and Warshaw, Christopher. 2013. “Measuring Constituent Preferences in Congress, State Legislatures, and Cities.” Journal of Politics 75 (2): 330–42..CrossRefGoogle Scholar
Thompson, Frank. 2012. Medicaid Politics: Federalism, Policy Durability and Health Reform. Washington, DC: Georgetown Press.Google Scholar
Todd, Susan R., and Sommers, Benjamin D.. 2012. “Overview of the Uninsured in the United States: A Summary of the 2012 Current Population Survey Report.” U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation. http://aspe.hhs.gov/health/reports/2012/UninsuredInTheUS/ib.shtmlGoogle Scholar
Train, Kenneth. 2009. Discrete Choice Methods with Simulation. 2nd ed. New York, NY: Cambridge University Press.Google Scholar
Weissert, Carol. 1992. “Medicaid in the 1990s: Trends, Innovations and the Future of the ‘PAC Man’ of State Budgets.” Publius 22 (3): 93–109..Google Scholar
Weissert, Carol, and Scheller, Daniel. 2008. “Learning from the States? Federalism and National Health Policy.” Public Administration Review 68 (Suppl. s1): S162–74.CrossRefGoogle Scholar
Wright, Gerald C., Erikson, Robert S., and McIver, John P.. 1987. “Public Opinion and Policy Liberalism in the United States.” American Journal of Political Science 31 (3): 980–1001..CrossRefGoogle Scholar
Zorn, Christopher. 2005. “A Solution to Separation in Binary Response Models.” Political Analysis 13 (2): 157–70..CrossRefGoogle Scholar