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The elephant in the room: why some states are refusing to expand Medicaid

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  • Russell S. Sobel

Abstract

After the US Supreme Court overturned the Affordable Care Act's mandate that states expand Medicaid, roughly half the states have declined to expand. Declining states blame the high state budgetary cost. While these states do have significantly higher expansion costs, they are also significantly more likely to have Republican Party control of the legislature and governor office. Statistical inquiry confirms that after controlling for costs, it is indeed political party control, particularly of the lower chamber of the state legislature that is the most important statistical determinant of state Medicaid expansion decisions.

Suggested Citation

  • Russell S. Sobel, 2014. "The elephant in the room: why some states are refusing to expand Medicaid," Applied Economics Letters, Taylor & Francis Journals, vol. 21(17), pages 1226-1229, November.
    • Handle: RePEc:taf:apeclt:v:21:y:2014:i:17:p:1226-1229
    DOI: 10.1080/13504851.2014.920469
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    References listed on IDEAS

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    1. Husted, Thomas A & Kenny, Lawrence W, 1997. "The Effect of the Expansion of the Voting Franchise on the Size of Government," Journal of Political Economy, University of Chicago Press, vol. 105(1), pages 54-82, February.
    2. Barrilleaux, Charles J. & Miller, Mark E., 1988. "The Political Economy of State Medicaid Policy," American Political Science Review, Cambridge University Press, vol. 82(4), pages 1089-1107, December.
    3. Weingast, Barry R & Shepsle, Kenneth A & Johnsen, Christopher, 1981. "The Political Economy of Benefits and Costs: A Neoclassical Approach to Distributive Politics," Journal of Political Economy, University of Chicago Press, vol. 89(4), pages 642-664, August.
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    Cited by:

    1. Peter T. Leeson & Henry A. Thompson, 2023. "Public choice and public health," Public Choice, Springer, vol. 195(1), pages 5-41, April.
    2. Sutter, Daniel, 2016. "The Political Economy of Medicaid Expansion: Federalism, Interest Groups, and the ACA," Working Papers 06860, George Mason University, Mercatus Center.

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