American Federalism in Practice
American Federalism in Practice

Author: Michael Doonan

Publisher: Brookings Institution Press

Published: 2013-08-30

Total Pages: 169

ISBN-13: 0815724837

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American Federalism in Practice is an original and important contribution to our understanding of contemporary health policy. It also illustrates how contentious public policy is debated, formulated, and implemented in today’s overheated political environment. Health care reform is perhaps the most divisive public policy issue facing the United States today. Michael Doonan provides a unique perspective on health policy in explaining how intergovernmental relations shape public policy. He tracks federal-state relations through the creation, formulation, and implementation of three of the most important health policy initiatives since the Great Society: the State Children’s Health Insurance Program (CHIP) and the Health Insurance Portability and Accountability Act (HIPAA), both passed by the U.S. Congress, and the Massachusetts health care reform program as it was developed and implemented under federal government waiver authority. He applies lessons learned from these cases to implementation of the Affordable Care Act. “Health policymaking is entangled in a complex web of shared, overlapping, and/or competing power relationships among different levels of government,” the author notes. Understanding federal-state interactions, the ways in which they vary, and the reasons for such variation is essential to grasping the ultimate impact of federalism on programs and policy. Doonan reveals how federalism can shift as the sausage of public policy is made while providing a new framework for comprehending one of the most polarizing debates of our time.

Federalism and Health Policy
Federalism and Health Policy

Author: Alan Weil

Publisher: The Urban Insitute

Published: 2003

Total Pages: 448

ISBN-13: 9780877667162

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The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.

Federalism and Decentralization in Health Care
Federalism and Decentralization in Health Care

Author: Gregory P. Marchildon

Publisher: University of Toronto Press

Published: 2018-01-01

Total Pages: 270

ISBN-13: 1487521545

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Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.

Comparative Health Care Federalism
Comparative Health Care Federalism

Author: Katherine Fierlbeck

Publisher: Routledge

Published: 2016-03-09

Total Pages: 374

ISBN-13: 1317163117

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Examining the changing nature of health care federalism within a competitive global context, Comparative Health Care Federalism provides a rich and nuanced account of the way in which the interplay of federal relationships impact health care within an array of systems. The editors have gathered together some of the leading international health policy scholars to provide detailed accounts of the dynamics of federal health policy-making within their respective jurisdictions. Complementing the theoretical and methodological objectives, this book provides a detailed, empirical description of the challenges faced by different states and the ways in which health policy-making works within the federal, quasi-federal, and functional federal systems presented. In chapters on the United States, Australia, Canada, Germany, Spain, Italy, Austria, the United Kingdom, the EU, India, China, Brazil, and the Russian Federation the authors consider what variables contribute to, and stand in the way of, the formation of robust and sustainable health care systems.

Health Policy, Federalism, and the American States
Health Policy, Federalism, and the American States

Author: Robert F. Rich

Publisher: The Urban Insitute

Published: 1996

Total Pages: 340

ISBN-13: 9780877666608

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In the ongoing struggle between those favoring centralized and those favoring decentralized government, health care policy is an important issue. This book has three goals: (1) to illustrate how theories of federalism and intergovernmental relations can provide a useful framework for examining how to "divide up the job" in the health care area, (2) to assess the capacity of the states to actually implement health care policy changes, and (3) to weigh the merits of alternative visions of the future role of states and the federal government in health care policy.

Obamacare Wars
Obamacare Wars

Author: Daniel Béland

Publisher: University Press of Kansas

Published: 2023-02-10

Total Pages: 248

ISBN-13: 0700635076

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Not five minutes after the Affordable Care Act (ACA) was signed into law, in March 2010, Virginia’s attorney general was suing to stop it. And yet, the ACA rolled out, in infamously bumpy fashion, and rolled on, fought and defended at every turn—despite President Obama’s claim, in 2014, that its proponents and opponents could finally “stop fighting old political battles that keep us gridlocked.” But not only would the battles not stop, as Obamacare Wars makes acutely clear, they spread from Washington, DC, to a variety of new arenas. The first thorough account of the implementation of the ACA, this book reveals the fissures the act exposed in the American federal system. Obamacare Wars shows how the law’s intergovernmental structure, which entails the participation of both the federal government and the states, has deeply shaped the politics of implementation. Focusing on the creation of insurance exchanges, the expansion of Medicaid, and execution of regulatory reforms, Daniel Béland, Philip Rocco, and Alex Waddan examine how opponents of the ACA fought back against its implementation. They also explain why opponents of the law were successful in some efforts and not in others—and not necessarily in a seemingly predictable red vs. blue pattern. Their work identifies the role of policy legacies, institutional fragmentation, and public sentiments in each instance as states grappled with new institutions, as in the case of the exchanges, or existing structures, in Medicaid and regulatory reform. Looking broadly at national trends and specifically at the experience of individual states, Obamacare Wars brings much-needed clarity to highly controversial but little-understood aspects of the Affordable Care Act’s odyssey, with implications for how we understand the future trajectory of health reform, as well as the multiple forms of federalism in American politics.

Medicaid Politics
Medicaid Politics

Author: Frank J. Thompson

Publisher: Georgetown University Press

Published: 2012-09-20

Total Pages: 289

ISBN-13: 1589019342

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Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise. 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. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system. In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.

Federalism and Social Policy
Federalism and Social Policy

Author: Scott L. Greer

Publisher: University of Michigan Press

Published: 2019-05-24

Total Pages: 339

ISBN-13: 0472131176

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Federalism and Social Policy focuses on the crucial question: Is a strong and egalitarian welfare state compatible with federalism? In this carefully curated collection, Scott L. Greer, Heather Elliott, and the contributors explore the relationship between decentralization and the welfare state to determine whether or not decentralization has negative consequences for welfare. The contributors examine a variety of federal countries, including Spain, Canada, and the United Kingdom, asking four key questions related to decentralization: (1) Are there regional welfare states (such as Scotland, Minnesota, etc.)? (2) How much variation is there in the structures of federal welfare states? (3) Is federalism bad for welfare? (4) Does austerity recentralize or decentralize welfare states? By focusing on money and policy instead of law and constitutional politics, the volume shows that federalism shapes regional governments and policies even when decentralization exists.

Federalism and the Response to COVID-19
Federalism and the Response to COVID-19

Author: Rupak Chattopadhyay

Publisher: Taylor & Francis

Published: 2021-11-29

Total Pages: 386

ISBN-13: 100051627X

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The COVID-19 pandemic bared the inadequacies in existing structures of public health and governance in most countries. This book provides a comparative analysis of policy approaches and planning adopted by federal governments across the globe to battle and adequately respond to the health emergency as well as the socio-economic fallouts of the pandemic. With twenty-four case studies from across the globe, the book critically analyzes responses to the public health crisis, its fiscal impact and management, as well as decision-making and collaboration between different levels of government of countries worldwide. It explores measures taken to contain the pandemic and to responsibly regulate and manage the health, socio-economic welfare, employment, and education of its people. The authors highlight the deficiencies in planning, tensions between state and local governments, politicization of the crisis, and the challenges of generating political consensus. They also examine effective approaches used to foster greater cooperation and learning for multi-level, polycentric innovation in pandemic governance. One of the first books on federalism and approaches to the COVID-19 pandemic, this volume is an indispensable reference for scholars and researchers of comparative federalism, comparative politics, development studies, political science, public policy and governance, health and wellbeing, and political sociology.

Guide to U.S. Health and Health Care Policy
Guide to U.S. Health and Health Care Policy

Author: Thomas R. Oliver

Publisher: CQ Press

Published: 2014-09-03

Total Pages: 1109

ISBN-13: 1483370453

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The contentious passage of the Affordable Care Act in 2010 highlighted the incredible complexity and controversy surrounding health care in the United States. While the U.S. federal government does not provide universal health care, it has an extremely wide reach when it comes to the health of its citizenry. From important scientific and medical research funding to infectious disease control and health services for veterans and the elderly, the pathway to legislation and execution of health policies is filled with competing interests and highly varied solutions. The Guide to U.S. Health and Health Care Policy provides the analytical connections showing researchers how issues and actions are translated into public policies and institutions for resolving or managing healthcare issues and crises. The Guide highlights the decision-making cycle that requires the cooperation of federal and state governments, business, and an informed citizenry in order to achieve a comprehensive approach to advancing the nation’s healthcare policies. Through 30 topical chapters, the book addresses the development of the U.S. healthcare system and policies, the federal agencies and public and private organizations that frame and administer those policies, and the challenges of balancing the nation’s healthcare needs with the rising costs of medical research, cost-effective treatment, and adequate health insurance. Additionally, the book comprehensively addresses significant disparities that exist in the U.S. system and the challenges to public health posed by our increasingly connected world. Taking a comprehensive approach, the Guide traces policy initiatives across time and takes into account the most recent scholarship: Part One: Evolution of American Health Care Policy Looks at the emerging and expanding role of government in the health care sector and the position the U.S. occupies today as the only advanced industrial nation without universal health care. Part Two: Government Organizations that Develop, Fund, and Administer Health Policy (1789-Today) Examines the role each branch of government plays in the forming, executing, and regulating health care policies. The authors examine the origins, organization, budget, and function of major government organizations including the FDA, CDC, and VA. An exploration of legal oversight and the roles states play in the health sector round out this section. Part Three: Contemporary Health Policy Issues: Goals and Initiatives (1920s-Today) Explores the wide range of players in the health care sphere and the role the government plays, particularly in funding them. Special attention is paid to policy issues surrounding medical research and medical professions. This section also looks at the ethical issues in play when making health policy and the inequalities that have plagued the U.S. health care system. Part Four: Contemporary Health Policy Issues: People and Policies (1960s-Today) This part of the book looks in-depth at health disparities in the U.S., health challenges particular to specific groups, mental health, obesity, and the influence of interest groups. Part Five: U.S. Response to Global Health Challenges (1980s-Today) The last section of the book looks beyond the borders of the United States and the serious challenges posed by our increasingly connected world.