The Politics of Need: Examining Governors' Decisions to Oppose the "Obamacare" Medicaid Expansion. (December 2014)

• Record Type: Journal Article
• Authors: Barrilleaux, Charles; Rainey, Carlisle
• Is Part Of: State politics & policy quarterly. Volume 14:Number 4(2014:Dec.)
• Page Start: 437
• Page End: 460
• Publication Date: 2014-12
• Subjects: health policy -- public policy -- governors -- executive politics -- legislative/executive interaction -- legislative politics -- federal/state -- federalism -- Bayesian statistics -- quantitative methods -- methodology; State governments -- United States -- Periodicals; Political planning -- United States -- States -- Periodicals; Gouvernements d'États fédérés -- États-Unis -- Périodiques; Politique publique -- États-Unis -- États -- Périodiques; 320.97305
• DOI: 10.1177/1532440014561644
• Languages: English
• ISSNs: 1532-4400

Abstract

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.