Tag: Children with Special Healthcare Needs in the United States

In her new book, Fragmented Democracy: Medicaid, Federalism, and Unequal Politics, Cornell University political scientist Jamila Michener explores Medicaid's effects on another crucial variable: political participation. It affects whether they engage and participate in political activity. These policy feedback effects vary from program to program, right? Then political scientists look at feedback effects for more typical welfare programs like cash assistance, and find the opposite: that those programs can really depress your political participation and make it less likely that you engage. It also makes the capriciousness of the government really clear: I once had this thing, but I don't know if I'll be able to have it next year because we get things and we get them taken away. What makes people more or less likely to participate? One of the things people would say to me when I first started getting this finding about Medicaid having a negative relationship to political participation was: "Well, conservatives are going to love this because they can say that these welfare programs are bad for democracy. The mechanism is when we design policy that is capricious, or that is ungenerous, or that is administratively burdensome, it contributes to experiences that alienate people from government and politics. But we don't think enough about the consequences of that system and that structure for inequality, both material—differences in the resources different Americans have access to for no reason other than their place of residence—and political inequality. Those are the places where Medicaid is likely to have a negative relationship to political participation because they're not expanding, and there are various forms of retrenchment and various kinds of punitive changes that are happening in those states with these waivers.