The Political Economy of Medicaid Expansion: Federalism, Interest Groups, and the ACA

摘要: Medicaid was established in 1965 as a joint state and federal program to provide medical insurance Americans who are poor have disabilities, it has grown from 1percent 3 percent of GDP. The source Medicaid’s growth over the past 50 years must inform efforts reform slow spending. literature on political economy provides strong evidence interest group ideological influence, enabled by open-ended match for strongest support matching grants drivers emerges studies discretionary coverages populations contrast program’s mandatory components. Evidence also exists that increases already eligible may lead offsetting reductions reimbursement rates, thus suggesting increased need (the cost adequate care poor) not been primary driver growth.