Markets, Medicare, and Making Do: Business Strategies After National Health Care Reform

Martin, Cathie Jo

doi:10.1215/03616878-22-2-557

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Steinmo and Watts (1995) argued that the U.S. does not have a national insurance system because American political institutions are biased against this type of reform. Martin (1995) argues that institutional efforts by large businesses in the U.S. helped to defeat national health care reform. Weissert and Weissert (1996) argue that national health insurance has not been adopted in the U.S. because, in part, of the differences between the two political parties on the role government should play in this arena.…”

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Health Reform in the States:A Model Of State Small Group Health Insurance Market Reforms

Stream

1999

Political Research Quarterly

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Reforms CHRISTOPHER STREAM, UNIVERSITY OF IDAHOFor the fourth time since World War II, national policymakers, in 1992, engaged in a major debate over reforming and regulating the U.S. health care system. One of the most debated issues involved the problem of the uninsured. While Congress and the President garnered national attention debating the issue, several states were already dealing with the issue of health insurance and their own uninsurance problems. Today, in the absence of activity at the federal level, the states have become the de facto leaders in health care reform. Since 1990, forty-six states have adopted small group insurance market reforms. Such reforms are designed to improve the availability of insurance coverage for employees of small firms, who make up the largest segment of the uninsured in the states. This article examines the factors that account for the sudden popularity of small group insurance market reforms, and the factors or characteristics of the states that explain the extent of policies adopted. To examine these questions, a pooled cross-sectional time series model is employed. The results indicate the factors contributing to the adoption of small group health insurance market reforms are a state's regulatory environment, a state's regulatory philosophy, state fiscal health, problem severity, and the activities of neighboring states. Implications of the findings are also discussed.In the absence of a coherent national health insurance policy, the American states have become the de facto leaders in health insurance reform. The states have always been important sites for the development of innovative solutions to the nation's health care problems (Weissert and Weissert 1996). State health NOTE: The author wishes to thank Charles Barrilleaux, Lisa D. Stream, and this journal's three anonymous reviewers for their helpful comments.

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confidence: 99%