Counterproductive Consequences of a Conservative Ideology: Medicaid Expansion and Personal Responsibility Requirements.

Abstract:

:Medicaid expansion, a key part of the Affordable Care Act, has been opposed by conservative politicians despite its fiscal and public health benefits. In response, some Republican-led states have expanded Medicaid with new reforms, including requirements for cost sharing and behavioral incentives, that promote conservative political values tied to an ideology of personal responsibility. We examine this trend using Michigan's Medicaid expansion as a case example. We explore the origins, evidence base, and possible consequences of these reforms. We argue that these reforms prioritize ideology over sound public health knowledge, deflecting attention away from the social, economic, and structural factors that influence the health of the poor, and may ultimately contribute to counterproductive public health and fiscal outcomes.

journal_name

Am J Public Health

authors

Baker AM,Hunt LM

doi

10.2105/AJPH.2016.303192

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

1181-7

issue

7

eissn

0090-0036

issn

1541-0048

journal_volume

106

pub_type

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