Inching Toward Universal Coverage: State-Federal Health-Care Programs in Historical Perspective

Haeder, Simon F.; Weimer, David L.

doi:10.1017/s0898030615000330

Cited by 18 publications

(16 citation statements)

References 59 publications

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“…The American health‐care system is a complex amalgam of private and public entities. In many cases, federal or state governments shoulder some, if not all, of the financial burden of a program but rely on private partners to provide services (Haeder & Weimer, ). Two major programs so structured are the Affordable Care Act's insurance marketplaces (Beland, Rocco, & Waddan, ) and Medicare Advantage (Haeder, ; Kelly, ).…”

Section: Introductionmentioning

confidence: 99%

A Tale of Two Programs: Access to High Quality Providers for Medicare Advantage and Affordable Care Act Beneficiaries in New York State

Haeder¹

2019

World Med & Health Policy

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Medicare Advantage and the Affordable Care Act's insurance marketplaces provide coverage to millions of beneficiaries. This paper assesses network design and access to percutaneous coronary intervention (PCI or angioplasty with stent) in New York for both programs. A specific focus is on access to higher quality providers. The findings indicate that both programs significantly restricted access and choice as compared to an unconstrained network. However, network design only rarely created areas devoid of any providers. In terms of access to quality, both programs tended to have slightly worse mean and median quality ratings than the overall physician supply. Findings with regard to access to above‐average providers were mixed. With respect to access to the highest quality providers, both ACA and Medicare Advantage plans generally fared slightly worse than unrestricted networks. In micropolitan and rural areas, access issues became apparent. Network regulation may do little to address these concerns. However, adding non‐emergency medical transportation benefits to insurance coverage may prove to be desirable going forward.

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Section: Introductionmentioning

confidence: 99%

A Tale of Two Programs: Access to High Quality Providers for Medicare Advantage and Affordable Care Act Beneficiaries in New York State

Haeder¹

2019

World Med & Health Policy

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“…K. Williams 1939). More important, various programs were implemented through a variety of shared-governance arrangements (Haeder and Weimer 2015a). These extensions "set a precedent for increased participation of state and federal governments in financing medical care for the needy" (Greenfield 1958: 25).…”

Section: The Rise and Decline Of Public Hospitalsmentioning

confidence: 99%

“…On the one hand, this entailed the temporary establishment of a number of support programs for able-bodied adults. Subsequent programs included the Reconstruction Finance Corporation, the Federal Emergency Relief Administration, the Civil Works Administration, and Works Progress Administration (Greenfield 1958;Haeder and Weimer 2015a;Macmahon, Millett, andOgden [1941] 1971). Particularly Rule and Regulation 7 issued by the Federal Emergency Relief Administration encourage the provision of medical care (Bernard and Feingold 1970;Bierman 1954).…”

Section: The Rise and Decline Of Public Hospitalsmentioning

confidence: 99%

“…Historically, local governments, closest to the people and confronted with their most immediate problems, have had to find solutions to public policy problems. This holds particularly true for individual and community welfare, policy areas that have generally been addressed only by state and national governments in more recent times (Haeder and Weimer 2015a). Hence, policy making of supralevel governments often does not occur on a blank policy terrain but instead is superimposed on policies previously implemented by local governments.…”

mentioning

confidence: 99%

“…The provision of public and personal health services is an interesting case because local governments have had to find solutions to these pressing problems long before state and federal governments intervened on a larger scale in the early 1900s (Haeder and Weimer 2015a). A common approach across most states has been the establishment of public hospitals, such as Philadelphia General Hospital, founded in 1731, and New York's Bellevue Hospital, founded in 1736 (Regenstein and Huang 2005).…”

mentioning

confidence: 99%

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The Demise of Community Responsibility: Unintended Consequences of Coverage Expansions on California Public Hospitals

Haeder

2018

Journal of Health Politics, Policy and Law

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Long before the establishment of Medicaid or the passage of the Affordable Care Act, California counties provided their poorest residents with access to comprehensive medical care. This article analyzes the creation and closure of public hospitals in the state of California. It combines both qualitative historical research and event history analysis to assess what led first to the creation of the nation's most comprehensive public health network and then to its gradual demise. Strong evidence is presented that the implementation of Medicaid in California significantly altered the calculus of local governments with regard to the operation of public hospitals. In particular, Medicaid shifted county hospitals from the realm of allocational politics to that of redistributive politics. Subsequently, reforms at the state and federal levels further encouraged this development. Because of this shift, many counties decided to close their hospitals. Moreover, as expected for redistributive policies, the continued operation of public hospitals was driven not by need but instead merely by fiscal capacity: more affluent counties continue to maintain them while poorer, needier counties close their doors.

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Stability and policy threats: US public opinion after a decade of the Affordable Care Act

Haeder,

Sylvester

2024

World Med & Health Policy

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The Affordable Care Act (ACA) continues to shape US politics at the elite level. We know less about whether this conflict still carries over to the broader public. Moreover, we know little about the degree to which the conflict reaches into its various policies and whether the policy threats to the ACA can affect public opinion. We fielded a large, and demographically diverse survey of US adults using Lucid (N = 6066) from July 8–21, 2020. The survey contained an experiment that introduced the topic to respondents as the 2010 health reform law, the ACA, or Obamacare and at times highlighted the potential undoing of the ACA by the US Supreme Court. Analyses were conducted using Ordinary Least Squares regression. Our findings indicate that perceptions of the ACA differ substantial based on partisanship and racial prejudice. Framing still matters in the minds of Americans and their perception of health reforms in general and its individual components by extending these differences. However, we find only very limited evidence for changes to public attitudes related to the policy threat of the Supreme Court ruling the ACA constitutional in California v. Texas. The ACA remains a political battleground in the minds of Americans. The politics of the ACA continue to be shaped by perceptions of race and partisanship.

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Inching Toward Universal Coverage: State-Federal Health-Care Programs in Historical Perspective

Cited by 18 publications

References 59 publications

A Tale of Two Programs: Access to High Quality Providers for Medicare Advantage and Affordable Care Act Beneficiaries in New York State

A Tale of Two Programs: Access to High Quality Providers for Medicare Advantage and Affordable Care Act Beneficiaries in New York State

The Demise of Community Responsibility: Unintended Consequences of Coverage Expansions on California Public Hospitals

Stability and policy threats: US public opinion after a decade of the Affordable Care Act

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