Cover

pdf iconDownload PDF
 

Contents

pdf iconDownload PDF
 

List of Illustrations

pdf iconDownload PDF

p. ix

read more

Acknowledgments

pdf iconDownload PDF

pp. xi-xii

In seeking to fathom the nature and origins of Medicaid durability from President Clinton to President Obama, I have benefited greatly from the assistance of others. I am deeply indebted to the Robert Wood Johnson Investigator Award Program for funding my research. The foundation’s generous support...

List of Abbreviations and Acronyms

pdf iconDownload PDF

p. xiii

read more

1. Medicaid and the Health Care Crucible

pdf iconDownload PDF

pp. 1-33

In early 2011 the House of Representatives’ Budget Committee passed a resolution supported by its Republican members calling for “fundamental reform” of Medicaid—a federal grant program to the states. Led by the committee chairman, Paul Ryan (R-WI), the Republicans on the committee...

read more

2. Dodging the Block Grant Bullet and Other Signs of Resilience

pdf iconDownload PDF

pp. 34-69

This chapter follows three significant developments for Medicaid’s durability in the 1993–2010 period. All three testify to the program’s political resilience. The first is the premise that one can learn much about the sources of a program’s strength by assessing failed legislative efforts at retrenchment. In this regard...

read more

3. Beyond Welfare Medicine: The Take-Up Challenge

pdf iconDownload PDF

pp. 70-100

In the decades leading up to 1993, many portrayed Medicaid as “welfare medicine.” This phrase had several connotations. In a general sense, it implied that Medicaid was second-class care that gave less access to high-quality services than others received through their insurance. But in the case of children...

read more

4. Government by Waiver: The Quest to Transform Long-Term Care

pdf iconDownload PDF

pp. 101-133

In late April 2005 a House of Representatives subcommittee on health opened a hearing on the need to reform long-term care under Medicaid to contain its “spiraling costs.” In his opening remarks at the session, Representative Charles Norwood (R-GA) observed that “Medicaid . . . is quickly becoming a welfare...

read more

5. Demonstration Waivers and the Politics of Reinvention

pdf iconDownload PDF

pp. 134-166

Within a month after taking office in January 1993, President Bill Clinton appeared at the winter meeting of the National Governors Association, a group with which he had been affiliated for twelve years as governor of Arkansas. The president spoke words the governors wanted to hear. Clinton deemed the...

read more

6. Reform: The Politics of Polarization

pdf iconDownload PDF

pp. 167-202

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act—an epic breakthrough to expand health insurance in the United States. This new law, commonly called the Affordable Care Act, or ACA, culminated a century of effort to insure all Americans. Theodore...

read more

7. Durability, Federalism, and the Future of Medicaid

pdf iconDownload PDF

pp. 203-235

From the dawn of the Clinton administration in January 1993 to the contentious politics of divided government under Barack Obama in 2011, dramatic political and economic changes buffeted Medicaid. At various intervals the two major parties won and lost control of Congress and the presidency. The...

Appendixes

pdf iconDownload PDF

pp. 237-240

References

pdf iconDownload PDF

pp. 241-262

Index

pdf iconDownload PDF

pp. 263-273