Journal of health politics, policy and law
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J Health Polit Policy Law · Aug 2007
Notes from the laboratories of democracy: state government enactments of market- and state-based health insurance reforms in the 1990s.
We identify two policy strategies that state governments pursue to reduce uninsurance, and we classify policies as being either state based or market based. The two policy strategies are distinguished by whether states rely on the institutional capabilities of the state or market processes to provide insurance. We develop and test models to explain states' adoptions of each type of policy. ⋯ Second, while market-based policy approaches may be the most feasible politically, they may be the least successful in remedying practical uninsurance issues. These results thus reveal that institutional characteristics of states create an important foundation for policy choice and policy success or failure. These results would suggest that the national government's strategy of pursuing market-based solutions to the problem will not result in its being solved.