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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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