Why 2018 could lead to more Medicaid expansion – Axios

August 4, 2017

It’s never too early to start thinking about the upcoming 2018 elections. And while a lot of the focus so far has been on the House, a handful of hotly contested gubernatorial races could have higher stakes for health care — specifically, for the Affordable Care Act’s Medicaid expansion.

A raft of open governors’ races next year will give Democrats a chance to replace some of the most stridently anti-expansion governors in the country — and, if they win even a few of those races, the chance to cover millions of currently uninsured people even as the Trump administration drags its heels on so much of the ACA.

Source: Why 2018 could lead to more Medicaid expansion – Axios


Larry J. Sabato’s Crystal Ball » Checking in on 2015’s Gubernatorial Races

February 12, 2015

The race Leans Republican, but perhaps Kentucky bucks its peers once again. If it does not, Republicans will likely end 2015 with 32 governorships, tying 1970 and 1998 for their post-World War II high in total number of governorships controlled.

via Larry J. Sabato’s Crystal Ball » Checking in on 2015’s Gubernatorial Races.


Democrats’ Downballot Troubles

December 5, 2014

Today, about 55 percent of all state legislative seats in the country are held by Republicans. That’s the largest share of GOP state legislators since the 1920s. Just 11 states have an all Democratic-controlled legislature, while Republicans have a legislative majority in 30 states, including the battleground states of Florida, Ohio, Pennsylvania, and North Carolina. Before the 2014 election, Democrats had single-party control (legislature and governor) in 15 states. Post-2014, that number is down to seven.

A continuing realignment in the South from Democratic stronghold to GOP bastion has contributed to GOP gains at the legislative level. In 1992, all 15 southern states (Texas, Oklahoma, Louisiana, Arkansas, Missouri, Kentucky, Tennessee, West Virginia, Virginia, North Carolina, South Carolina, Georgia, Mississippi, Alabama, and Florida) had Democratic-controlled legislatures. Today, they are all Republican but for Kentucky which has split control. It’s not just the South however. Since 2012, notes the NCSL, Republicans have picked up seats in every region of the country.

via Democrats’ Downballot Troubles.


Tie to Obama’s Health Law Proves Risky for Arkansas Republican – WSJ

June 7, 2014

Arkansas legislator John Burris says he is a staunch opponent of President Barack Obama’s health-care expansion.But after helping to engineer a compromise that allowed Arkansas to use dollars aimed at broadening Medicaid coverage to enroll poorer residents in private health insurance, the Republican finds himself in a tough runoff election Tuesday against an opponent who has played up his link to the Affordable Care Act.

via Tie to Obama’s Health Law Proves Risky for Arkansas Republican – WSJ.


Public Health and Agenda Setting: Determinants of State Attention to Tobacco and Vaccines

March 7, 2014

What determines government attention to emerging health issues? We draw on research in agenda setting and policy diffusion to explore the determinants of public health attention in the fifty American states. We find that intergovernmental influence has a strong and consistent influence over state attention to tobacco and vaccines from 1990 to 2010. While national attention to tobacco or vaccines also sparks attention in the states, this effect is smaller than the internal impact of gubernatorial attention and the horizontal influence of neighboring state attention. We find some support that problem severity matters; however, these results are highly dependent on the measures used. Finally, we find no evidence that interest groups influence the attention that states pay to tobacco or vaccines. Our results suggest that institutions play a critical role in explaining government attention to health policy.

via Public Health and Agenda Setting: Determinants of State Attention to Tobacco and Vaccines.


As the Nation Goes, So Goes Maine?

March 7, 2014

Historically, Maine has been a state with generous safety net programs and a track record of innovative efforts in health system reform, developed under the leadership of Democratic administrations and with frequent support from moderate Republicans. But the 2010 elections in Maine dramatically changed the political balance of power, anointing both a governor and legislature ideologically at odds with the state’s recent political past. Maine has become a bastion of resistance to the Patient Protection and Affordable Care Act, with a reduced Medicaid program, defunded state access initiative, and no state exchange. In addition, the state has adopted a laissez-faire approach to insurance market dysfunction. Using Maine as a case study of the shifts in national political mood, this article describes in broad brushstrokes Maine’s history of health reform efforts and recent shift in political direction, and discusses some of the factors that contributed to the change.

via As the Nation Goes, So Goes Maine?.


Pascal’s Wager: Health Insurance Exchanges, Obamacare, and the Republican Dilemma

February 17, 2014

Enactment of the Patient Protection and Affordable Care Act (ACA) created a dilemma for Republican policy makers at the state level. States could maximize control over decision making and avoid federal intervention by establishing their own health insurance exchanges. Yet GOP leaders feared that creating exchanges would entrench a law they intensely opposed and undermine legal challenges to the ACA. Republicans’ calculations were further complicated by uncertainty over the Supreme Court’s ruling on the ACA’s constitutionality and the outcome of the November 2012 elections. In the first year of operation, only seventeen states and the District of Columbia chose to design and implement their own exchanges; another six partnered with the federal government, and twenty-seven states ceded control to Washington. Out of thirty states with Republican governors in 2013, only four launched their own exchange. Why did many Republican-led states that initially appeared open to establishing exchanges ultimately reverse course? Drawing on interviews with state policy makers and secondary data, we trace the evolution of Republican responses to the exchange dilemma during 2010–13. We explore how exchanges became controversial and explain why so few Republican-led states opted for their own exchange, focusing on the intensifying resistance to Obamacare amid a rightward shift in state politics, partisan polarization, and uncertainty over the ACA’s fate.

Freely available online through the Journal of Health Politics, Policy and Law open access option.

via Pascal’s Wager: Health Insurance Exchanges, Obamacare, and the Republican Dilemma.