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State Politics, Fiscal Stability, and Needy Group: A Study on State Children’s Health Insurance Program Design

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This study investigates factors accounting for states’ SCHIP type choice. Based on federal guidelines, state governments have huge discretion and flexibility to design SCHIP policy structures. However, previous research failed to find influential factors that determine SCHIP types among S-SCHIP, M-SCHIP and C-SCHIP. In this study, the authors attempt to explain the variation among three SCHIP types, and three SCHIP types are explained by state politics, fiscal stability and needy group. State politics is an invaluable dimension to explain SCHIP type choice, specifically that political and citizen ideology, gubernatorial budgetary power and majority politics differently determine. Still, fiscal stability and needy group have to consider policy consistency, policy safeguards and social responsibility in order to increase SCHIP enrollment, outreach and administrative capability. Based on statistical results, this study confirms that democratic dominance of both senate and house are more likely to choose a Medicaid expansion, but democratic dominance of governor, senate and house are more likely to provide separated structure at SCHIP type design. Governors having strong budgetary power have a willingness to provide a separate structure(S-SCHIP). Liberal citizens prefer to design a combination type of SCHIP. Finally, this research provides advanced literature on SCHIP, and then constructs the applicable hypotheses to investigate the variation in the SCHIP type choice in terms of state governmental discretion and flexibility.

Abstract

This study investigates factors accounting for states’ SCHIP type choice. Based on federal guidelines, state governments have huge discretion and flexibility to design SCHIP policy structures. However, previous research failed to find influential factors that determine SCHIP types among S-SCHIP, M-SCHIP and C-SCHIP. In this study, the authors attempt to explain the variation among three SCHIP types, and three SCHIP types are explained by state politics, fiscal stability and needy group. State politics is an invaluable dimension to explain SCHIP type choice, specifically that political and citizen ideology, gubernatorial budgetary power and majority politics differently determine. Still, fiscal stability and needy group have to consider policy consistency, policy safeguards and social responsibility in order to increase SCHIP enrollment, outreach and administrative capability. Based on statistical results, this study confirms that democratic dominance of both senate and house are more likely to choose a Medicaid expansion, but democratic dominance of governor, senate and house are more likely to provide separated structure at SCHIP type design. Governors having strong budgetary power have a willingness to provide a separate structure(S-SCHIP). Liberal citizens prefer to design a combination type of SCHIP. Finally, this research provides advanced literature on SCHIP, and then constructs the applicable hypotheses to investigate the variation in the SCHIP type choice in terms of state governmental discretion and flexibility.

참고문헌 (73)

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