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Publications by Joshua M. Wiener for Health Policy Center

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State and Federal Roles in Health Care (Article)
Randall R. Bovbjerg, Joshua M. Wiener, Michael Housman

This chapter explains how American federalism apportions responsibility for domestic policy between federal and state governments, and sometimes localities, often in overlapping ways. Arguments for relying on states versus the federal government can be grounded in political philosophy. Market principles also contribute to federalism debates. Finally, pragmatic considerations seem most important for most issues, most of the time. Citizens and policymakers decide what government performs best on a particular issue in their era. Thus, how states have exercised their enhanced authority in our New Federalism era matters a great deal. (25-57 in Federalism and Health Policy, edited by John Holahan, Alan Weil, and Joshua M. Weiner (Washington, DC: The Urban Institute Press, July 2003).)

Posted: January 11, 2006Availability: HTML

Federalism and Health Policy (Book)
Joshua M. Wiener, John Holahan, Alan Weil

The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children’s Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.

Posted: July 20, 2003Availability: HTML | Order Online

Health Policy for Low-Income People: Profiles of 13 States (Occasional Paper)
Amy Westpfahl Lutzky, John Holahan, Joshua M. Wiener

Based on site visit interviews with state officials, consumers, providers, and reviews of public documents and web sites, this report summarizes what happened to health care policy over the last few years in each of the following states: Alabama, California, Colorado, Florida, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, New York, Texas, Washington, and Wisconsin. Among some of the general patterns found: Medicaid rolls dropped between 1995 and 1998 because of the improved economy and welfare reform, but have increased in more recent years. Welfare reform also allowed states to expand Medicaid eligibility to families with much higher incomes than previously. States responded to the enactment of SCHIP in 1997 by expanding coverage for children in families with relatively high incomes.

Posted: May 01, 2002Availability: HTML | PDF


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