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Explaining Racial and Ethnic Variations in the Effects of State Policies to Increase Health Insurance Coverage, 1995-2005

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Abstract:

State governments make important decisions regarding access to health care within their borders. States have been especially active in this domain since the mid-1990s, when the failure of the Clinton Administration’s ill-fated attempt to provide universal coverage made clear the difficulty of bringing unified change to a famously fragmented system. This realization led both supporters and opponents of Clinton-style reforms to focus their energies on the states as policy venues, where they reasoned they might be more successful in bringing about or avoiding change. This paper assesses the “who gets what” of those policy changes that occurred during the 1990s: We assess the impact of state health policies on rates of insurance coverage for white, Hispanic, and African American citizens. To do this, we regress rates of insurance coverage for each group on indicators of state health policy that indicate whether particular policies designed to boost insurance coverage have been adopted by a state. Initial results indicate that policies provide differential benefits to different groups within the state: African-American citizens are more advantaged by Medicaid expansions, for example, and those policies appear to reduce insurance coverage among Hispanics. Whites are more advantaged by policies that encourage businesses to provide insurance than are Hispanics although each group shows small gains in insurance coverage following adoptions of those policies; African Americans are disadvantaged by those policies. In some exploratory work we regress ratios of groups’ insurance coverage (e.g., White:African-American, African-American:Hispanic, White:Hispanic) on policy and other controls. We find that demographic representation in legislatures, i.e. the percentage of seats held by members of a racial or ethnic groups, affects “who gets what” in that groups with better representation are rewarded with better coverage, and that reward comes at a cost to other groups.

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state (130), health (130), american (93), polici (80), coverag (75), latino (74), african (68), insur (63), uninsur (59), hispan (54), group (45), care (45), rate (39), polit (39), base (38), competit (36), 0 (34), white (32), black (32), effect (31), ethnic (30),
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Name: Southern Political Science Association
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http://www.spsa.net


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MLA Citation:

Barrilleaux, Charles. and Sanchez, Gabriel. "Explaining Racial and Ethnic Variations in the Effects of State Policies to Increase Health Insurance Coverage, 1995-2005" Paper presented at the annual meeting of the Southern Political Science Association, Hotel Intercontinental, New Orleans, LA, Jan 07, 2009 <Not Available>. 2009-11-04 <http://www.allacademic.com/meta/p283363_index.html>

APA Citation:

Barrilleaux, C. and Sanchez, G. , 2009-01-07 "Explaining Racial and Ethnic Variations in the Effects of State Policies to Increase Health Insurance Coverage, 1995-2005" Paper presented at the annual meeting of the Southern Political Science Association, Hotel Intercontinental, New Orleans, LA Online <APPLICATION/PDF>. 2009-11-04 from http://www.allacademic.com/meta/p283363_index.html

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: State governments make important decisions regarding access to health care within their borders. States have been especially active in this domain since the mid-1990s, when the failure of the Clinton Administration’s ill-fated attempt to provide universal coverage made clear the difficulty of bringing unified change to a famously fragmented system. This realization led both supporters and opponents of Clinton-style reforms to focus their energies on the states as policy venues, where they reasoned they might be more successful in bringing about or avoiding change. This paper assesses the “who gets what” of those policy changes that occurred during the 1990s: We assess the impact of state health policies on rates of insurance coverage for white, Hispanic, and African American citizens. To do this, we regress rates of insurance coverage for each group on indicators of state health policy that indicate whether particular policies designed to boost insurance coverage have been adopted by a state. Initial results indicate that policies provide differential benefits to different groups within the state: African-American citizens are more advantaged by Medicaid expansions, for example, and those policies appear to reduce insurance coverage among Hispanics. Whites are more advantaged by policies that encourage businesses to provide insurance than are Hispanics although each group shows small gains in insurance coverage following adoptions of those policies; African Americans are disadvantaged by those policies. In some exploratory work we regress ratios of groups’ insurance coverage (e.g., White:African-American, African-American:Hispanic, White:Hispanic) on policy and other controls. We find that demographic representation in legislatures, i.e. the percentage of seats held by members of a racial or ethnic groups, affects “who gets what” in that groups with better representation are rewarded with better coverage, and that reward comes at a cost to other groups.

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Document Type: application/pdf
Page count: 30
Word count: 7913
Text sample:
Variations in the Effects of State Health Reforms on White Hispanic and African American Citizens Charles Barrilleaux Gabriel Ramon Sanchez Robert Preuhs Florida State University University of New Mexico Metropolitan State cbarrilleaux@fsu.edu sanchezg@unm.edu College of Denver rpreuhs@mcsd.edu Abstract We examine the effects of 1990s-era state government health care reforms on rates of insurance coverage among all citizens under 65 all white citizens under 65 all Hispanic citizens under 65 and all African American citizens under 65. Our results indicate
Timothy A. and Shruti Rajan. 2000. “Race and Ethnic Disparities in Health Care Access and Utilization: An Examination of State Variation.” Medical Care Research Review 57 Supp.1: 55-84. Wienack R. M. and N.A. Kraus. 2000. “Racial/Ethnic Differences in Children’s Access to Care.” American Journal of Public Health 90: 1771-1774. Weinack Robin M. Samuel H. Zuvekas and Joel W. Cohen. 2000 “Racial and Ethnic Differences in Access to and Use of Health Care Services 1977-1996.” Medical Care Research Review 57


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