2015
DOI: 10.1177/0095399715581030
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Understanding the Implementation of Medicaid and Medicare: Social Construction and Historical Context

Abstract: This article examines the history and formation of Medicare and Medicaid to determine how America's two major public health insurance programs came to have such vastly different implementation structures. Drawing upon theories of social construction and path dependence, findings show how the programs were set on divergent paths. This article also explores how the intergovernmental nature of Medicaid has promoted inequities, both between programs and among recipients across states. The findings show how social … Show more

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Cited by 13 publications
(18 citation statements)
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“…This assumption may be convenient, but it is obviously both illogical and empirically inaccurate” (Frederickson, , p. 228). As the notion of “feed‐forward effects” entails (Pierce et al, ) and the recent policing crisis in the United States amply demonstrates, an unequal treatment of target groups by bureaucracies has wide‐ranging consequences for democracy and society at large (deLeon & Weible, ; Epp et al, ; Liang, ; Piatak, ). Discrimination in policy implementation has decisive impacts on both the attitudes and political behavior of the respective group and the public perception of this group.…”
Section: Discussionmentioning
confidence: 99%
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“…This assumption may be convenient, but it is obviously both illogical and empirically inaccurate” (Frederickson, , p. 228). As the notion of “feed‐forward effects” entails (Pierce et al, ) and the recent policing crisis in the United States amply demonstrates, an unequal treatment of target groups by bureaucracies has wide‐ranging consequences for democracy and society at large (deLeon & Weible, ; Epp et al, ; Liang, ; Piatak, ). Discrimination in policy implementation has decisive impacts on both the attitudes and political behavior of the respective group and the public perception of this group.…”
Section: Discussionmentioning
confidence: 99%
“…Both experimental and field research suggest that persisting stereotypes, in terms of simplified cognitive representations of how members of a distinct group are similar or different from members of other groups, provoke discrimination of immigrants during service delivery, especially in interaction with gender (Brodkin, 1993;Einstein & Glick, 2017;Fineman, 1998;Gooden, 2006;Grohs, Adam, & Knill, 2016;Johnson, 2012;Liang, 2016;Lipsky, 1980;Monnat, 2010;Moynihan & Herd, 2010;Nicholson-Crotty & Nicholson-Crotty, 2004;Piatak, 2015;Schram et al, 2010;Watkins-Hayes, 2009). Normative individual assessments of deservingness become particularly salient when welfare agents need to cope with austerity pressures that force them to prioritize some clients over others (Maynard-Moody & Musheno, 2012;Tummers, Bekkers, Vink, & Musheno, 2015).…”
Section: Social Constructions In Welfare Policy Deliverymentioning
confidence: 99%
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“…While cross‐sectional analysis cannot speak directly to how preferences for regulatory centralization change over time, a finding that variation in risk attitudes across individuals relates to their regulatory preferences is a first step in drawing attention to a mechanism that might underlie such change—particularly since ample evidence shows that risk attitudes vary over time and are sensitive to exogenous shocks, as well as media and elite framing (Albertson & Gadarian, ; Merolla & Zechmeister, ; Slovic, ; Slovic et al, ; Wildavsky & Dake, ). Likewise, understanding the micro‐foundations for preferences for uniformity and centralization is important to understanding regulatory outcomes because the level of government at which policy is pursued privileges different interests in the various stages of the policy process, and sets the terms for future regulatory capacity at the local, state, federal, and even supranational levels (Baumgartner & Jones, ; Piatak, ; Pralle, ; Sabatier & Jenkins‐Smith, ; Smith, Marsden, & Flynn, ).…”
Section: Introductionmentioning
confidence: 99%
“…Children 363,364,365,366 and elderly people are treated as deserving, 367,368 as are the disabled, 369 with some caveats. 370,371 Families are viewed favorably, 372 but single-parent households less so. 373,374,375 Table 2 summarizes the groups and behaviors used in past constructions of deservingness or lack thereof as suggested by the aforesaid literature, roughly identifying how groups, or groups qua behaviors, have been used as foils against each other in politics according to that literature.…”
Section: What Themes That Have Served As Messages About Beneficiary 'mentioning
confidence: 99%