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
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.
Subjects: Health Sciences, Political Science
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