Universal health care was on the national political agenda for nearly a hundred years until a comprehensive (but not universal) health care reform bill supported by President Obama passed in 2010. The most common explanation for the failure of past reform efforts is that special interests were continually able to block reform by lobbying lawmakers. Yet, beginning in the 1970s, accelerating with the failure of the Clinton health care plan, and continuing through the passage of the Affordable Care Act in 2010, health policy reform was alive and well at the state level.
Interest Groups and Health Care Reform across the United States assesses the impact of interest groups to determine if collectively they are capable of shaping policy in their own interests or whether they influence policy only at the margins. What can this tell us about the true power of interest groups in this policy arena? The fact that state governments took action in health policy in spite of opposing interests, where the national government could not, offers a compelling puzzle that will be of special interest to scholars and students of public policy, health policy, and state politics.
Table of Contents
Preface and Acknowledgments
Introduction: Interests and Health Policy
1. Health Care and Organized Interests in the United States
2. The Theory and Structure of Health Interest Communities in the States
3. State Pharmacy Assistance Programs as Innovations
4. The Politics of Managing Managed Care
5. Universal Health Care in the States
6. Conclusion: Lessons Learned and Opportunities for Influence in the ACA Policy Environment
Appendix 2.1: Descriptions of Health Interest Organization Subguilds
Appendix 2.2: States Ranked by Health Interest Group Density
Appendix 2.3: Density by Subguild, Raw Numbers in 1998
Appendix 2.4: Data Source for Political Action Committes
Appendix 3.1: List of Data Sources
Appendix 3.2: Estimation of Annual Interest Group Measures Using the ESA Model
Appendix 4.1: Data Sources of Dependent Variables
Appendix 4.2: Managed Care Regulation Descriptive Statistics
Appendix 4.3: Definitions and Sources of Independent Variables
Appendix 5.1: Sources of Dependent Variables
Appendix 5.2: Sources of Independent Variables
References
Index
Reviews
"A valuable addition to the very timely debate on health care policy in the US . . . incredibly comprehensive in its scope . . . provides huge amounts of data; and is filled with exhaustive terminology and advanced statistics."—Choice
"Makes a major contribution to an understanding of what influences state and national health policy. . . . Adds insight and breaks new ground in a critical branch of political science."—Perspectives on Politics
"The foremost scholars of interest groups take on the major domestic issue of our time—health care reform. By using the multitude of state actions in this area over the past generation, Gray, Lowery, and Benz shed more light on the politics of health care in the United States than ten books on the PPACA."—Christopher Z. Mooney, University of Illinois, Springfield
"The most comprehensive starting point for analyzing state health reform and understanding its future directions. Interest Groups and Health Care Reform across the United States will inform and stimulate a new generation of research on the politics of state health reform and the role of interest groups. A must read for students of health reform, state policy innovation, and American politics."—Lawrence R. Jacobs, University of Minnesota
About the Author
Virginia Gray is Robert Watson Winston Distinguished Professor of Political Science, University of North Carolina, Chapel Hill.
David Lowery is Bruce R. Miller and Dean D. LaVigne Professor of Political Science at Pennsylvania State University
Jennifer K. Benz serves as a senior research scientist for NORC at the University of Chicago.
