Fragmented Democracy
Medicaid, Federalism, and Unequal Politics

Because of federalism, Medicaid takes very different forms in different places. This has dramatic and crucial consequences for democratic citizenship.

Jamila Michener (Author)

9781316510193, Cambridge University Press

Hardback, published 22 March 2018

236 pages, 16 b/w illus. 3 maps 11 tables
23.5 x 15.6 x 1.8 cm, 0.46 kg

'The book … contributes to our understanding of minority politics and racial inequality in the American context, as Medicaid disproportionally serves people of color who live in or near poverty. At the micro-level, the author does an exceptional job putting a face to those who experience the injustices of the Medicaid system.' Mariely Lopez-Santana, Publius: The Journal of Federalism

Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.

1. Medicaid, political life and fragmented democracy
2. Federalism, citizenship and contextualized policy feedback
3. Federalism, healthcare and inequity: past and present
4. The mis(education) of Medicaid beneficiaries in the American states
5. Pushing back: particularistic resistance in county contexts
6. Going local: people, places and social policy in the city
7. Nothing about us, without us: policy advocacy in a fragmented polity
8. Federalism, policy and political inequality
References
Appendix A: qualitative interviews
Appendix B: statistical tables
Index.

Subject Areas: Medical insurance [MBPR], Political science & theory [JPA], Politics & government [JP], Social welfare & social services [JKS], Population & demography [JHBD], Social research & statistics [JHBC], Sociology [JHB], Social discrimination & inequality [JFFJ], Society & culture: general [JF], Society & social sciences [J]