American Social Policy Research Articles

Are Press Depictions of Affordable Care Act Beneficiaries Favorable to Policy Durability?

If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability--meaning both avoidance of outright retrenchment and fidelity to its policy aims--is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability. This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary "deservingness" in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Using manual and automated methods, this paper analyzes newspaper text from August 2013 through January 2014 to trace portrayals of two ACA "target populations" before and during the new law's first open-enrollment period: those newly eligible for Medicaid, and those eligible for subsidies to assist in the purchase of private health insurance under the ACA. This paper also studies newspaper text portrayals of two groups informally crafted by the ACA in this timeframe: those gaining health insurance and those losing it. The text data uncover the following answers to the three descriptive questions for the timeframe studied: (1) Portrayals may underplay beneficiaries' economic heterogeneity. (2) Portrayals pay little attention to young adults. (3) Portrayals emphasize themes of workforce participation, economic self-sufficiency, and insider status. Health status, age, gender, and race/ethnicity appear to receive little attention. Existing literature suggests that these portrayal patterns may both support and limit ACA durability. In favor of durability is that ACA beneficiaries are depicted in terms that have been associated with deservingness in past American social policy--particularly being cast as workers and insiders. Yet, the results also give three reasons for caution. First, ACA insurance-losers are also portrayed as deserving. Second, it is unclear how the portrayal patterns found may impact the durability of the ACA's efforts to cut insurance disparities by age, health status, and especially race/ethnicity. Third, portrayals' strong casting of beneficiaries as workers, and limited attention to beneficiaries' economic heterogeneity and to young adults, may do little to help cultivate beneficiary political engagement around the ACA.

The meanings of universal health care in Latin America.

In Latin America, competing definitions of universal health care are found. Variants include traditional universalism, basic universalism, and minimal or residual universalism. These definitions are informed by European traditions, a renewed emphasis on equity among Latin American social policy experts, and World Bank strategy. This essay explores these definitions as well as areas of overlap and points of difference between and among them using examples from several Latin American countries. The most important difference concerns the preventive and curative services not covered by the benefits packages of minimal universal programs, a gap expected to grow increasingly costly for patients.

Health Reform and the Future of American Politics

The Affordable Care Act of 2010 (ACA) is a landmark in American social policy that is disrupting America’s “liberal tradition.” It is successfully expanding access and compelling insurers to change their business models to serve more socially-useful purposes; cost control enjoyed initial success but confronts barriers rooted in America’s resilient political economy. The ACA is disrupting long-standing patterns of American politics, introducing new developmental paths that unsettle or, in certain respects, offset the familiar patterns of selectivity, deference to private markets, and “drift” that tend to produce government inaction as economic insecurity increases. New policy arrangements for financing and delivering medical care is ushering in a new politics of US health care that are resetting the terms of future debate; the ACA is also challenging familiar approaches to studying politics including analyses of framing, policy effects and political development, and American political thought.

Democracy and the Left: Social Policy and Inequality in Latin America

Democracy and the Left: Social Policy and Inequality in Latin America

The Effect of Unions and Organized Civil Society on Social Policy: Pension and Health Reforms in Argentina and Brazil, 1988–2008

AbstractThis article shows how modified European power resources theories can be applied to Latin America to explain differences in the depth of policy reforms. It innovates on previous work on Latin American social policy by particularly examining the effect of unions and other civil society groups on the process of structural reforms (or lack thereof) in the health and pension sectors in Argentina and Brazil. Through a most similar system design, this analysis shows that the strength and support (or opposition) of organized civil society groups is a crucial condition to account for the enactment (or failure) of a given broad policy reform.

Policy Information and the Polarization of American Social Policy Preferences

A burgeoning literature has found that “submerged” social policies – those delivered through non-state actors or the tax code – are less visible to citizens, meaning that citizens are less capable of forming informed preferences about those policies. But even non-submerged policies provided directly by the state can be highly complex. In these cases, how does the provision of policy-specific information change individuals’ opinions about the social program? We examine how the provision of information about the rules governing unemployment insurance affects individuals’ preferences for, and perceptions of, unemployment insurance benefits using a survey experiment. We find that policy-specific information produces a moderating effect on individuals’ opinions, making conservatives more likely to hold more liberal attitudes about program features and beneficiaries while making liberals hold more conservative attitudes. Our results are strongest for those individuals who were less knowledgeable about the program before our experiment. We thus argue that the polarization of public opinion regarding social programs like unemployment insurance is shaped, in part, by the availability of policy-specific information disseminated by the state and other actors, such as interest groups and the media.

Progress toward Self-Sufficiency for Low-Wage Workers

Over the last decade, American social policy has increasingly focused on encouraging and requiring work for those receiving government supports. This study analyzes the dynamics of the low-wage labor market and the role of work supports in helping workers move toward economic self-sufficiency. Monthly data from January 2001 through January 2003 shows that over one-quarter of workers earn low wages. We find evidence that low-wage workers are moving to higher-wage jobs, but two years later, the majority of low-wage workers either remain in low-wage jobs or are not working. Our analysis provides some, although limited, evidence that government-provided work supports promote self-sufficiency.

State Medicaid Policy and Health Reform

In July 2012, the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). The Court thus ended one phase in the political and legal battle over health reform. Yet in doing so, it opened a new front. In a notable departure from post– New Deal commerce clause jurisprudence, the Court ruled that the federal government could not require states that receive federal funds under the Medicaid program to participate in the PPACA’s Medicaid expansion. In effect, the Court made states’ participation in the PPACA’s Medicaid expansion voluntary — a possibility that neither the act’s supporters nor its opponents seriously entertained during the long legislative battle of 2009 and 2010. The full implications of these changes in federalstate relations remain to be seen. For states, the ruling brings both new flexibility and new accountability. Conservative legislators who have traditionally railed against Medicaid while accepting large subsidies will now have to actively accept or reject billions of dollars in federal resources made possible through this program. For the federal government, the ruling brings new uncertainties and complication, as states decide whether and when to participate in the PPACA’s Medicaid expansion. For millions of citizens, this decision likely delays the path to nearuniversal coverage envisioned under the new law. This issue’s PointCounterpoint essays underscore the difference in perspective among informed participants regarding what may be the most complex and contested measure in the history of American social policy.

Confronting Low Pay: Minimum Wage Policy and Employment in the U.S. and France

Nearly one-third of all American workers are paid very low wages, the highest rate among wealthy nations. An incidence of low pay at this level has obvious implications for the current standard of living for a substantial share of American families. But of particular concern are the implications for the future: the low pay rate has risen precipitously for young male workers with each economic downturn since the late 1970s. In stark contrast, over the last three decades France has adopted a minimum wage policy designed to eliminate low pay, and it has worked: the low-wage share has dropped to just 10 percent. But does the French evidence confirm the conventional prediction that a minimum wage high enough to substantially reduce the incidence of low pay will also eliminate large numbers of jobs for young, less-educated workers? We find no support for this view in the aggregate data. Despite the large and growing gap in the value of the US and French minimum wage since the mid-1990s, French unemployment and employment rates show stability or improvement as well as strong convergence to U.S. levels. Unemployment-to-population rates for US and French 15-24 year olds have closely tracked one another since the mid-1990s. At the same time, the US and French shares of the employed with a wage above the low-wage threshold and not working involuntarily part-time show a steady and substantial divergence in France’s favor, and this appears most dramatically for young less educated workers. France has shown that a rising minimum wage can all but eliminate low paid work without worsening employment opportunities for vulnerable workers. Making work pay for the bottom third of the workforce should be a top priority for American social policy.

Counting the homeless: the culture of quantification in American social policy

This commentary reflects on the practice of counting the homeless within political jurisdictions (i.e., homeless counts) within the United States to satisfy a cultural practice of quantification within American social policy. It discusses the problems arising from the cultural preference for quantification as the means of identifying and addressing a social problem with specific examples from US homeless assistance programs and participant observation in Long Beach, California. The culture of quantification is apparent in explanations for why counts are done, the disproportionate attention paid to measurement methods over reflection on interpretation of and responses to the numbers, and the general failure to effectively link the practice of counting to the causes of and solutions to homelessness. This focus diverts attention from real data needs and effective interpretation of data, consumes resources better used elsewhere, and generates among well-meaning people, particularly count volunteers, a false sense that they are addressing a problem simply by quantifying it. The commentary concludes with suggestions for examining how counts are actually used in modifying existing programs to evaluate the effectiveness of these quantification practices.

Limits to Progress and Change: Reflections on Latin American Social Policy

Limits to Progress and Change: Reflections on Latin American Social Policy

High court sanctions law edging US toward universal health coverage

The massive law pushing the United States toward universal health coverage won Supreme Court validation on June 28 in a decision that advances the most ambitious reshaping of American social policy in generations. The court’s historic 5–4 ruling handed President Barack Obama a stunning election

Putting Two and Two Together? Early Childhood Education, Mothers’ Employment and Care Service Expansion in Chile and Mexico

In recent years, several middle-income countries, including Chile, Mexico and Uruguay, have increased the availability of early childhood education and care (ECEC) services. These developments have received little scholarly attention so far, resulting in the (surely unintended) impression that Latin American social policy is tied to a familialist track, when in reality national and regional trends are more varied and complex. This article looks at recent efforts to expand ECEC services in Chile and Mexico. In spite of similar concerns over low female labour force participation and child welfare, the approaches of the two countries to service expansion have differed significantly. While the Mexican programme aims to kick-start and subsidize home- and community-based care provision, with a training component for childminders, the Chilean programme emphasizes the expansion of professional ECEC services provided in public institutions. By comparing the two programmes, this article shows that differences in policy design have important implications in terms of the opportunities the programmes are able to create for women and children from low-income families, and in terms of the programmes’ impacts on gender and class inequalities. It also ventures some hypotheses about why the two countries may have chosen such different routes.

Worlds Apart: Social Policy Regimes in Latin America

The region of Latin America exhibits significant diversity with regard to the size and scope of social protection programs. In this article, I propose a new way of measuring a country’s “social policy regime,” moving past expenditure-based conceptions of welfare provision to incorporate the coverage of programs. Employing this new measure, I use cluster analysis to demonstrate that Latin American social policy regimes cluster into four distinct categories. I then employ the comparative historical method to test a theory of why countries fall into each of these four categories. The analysis provides evidence that a country’s record of industrialization, the nature of political incorporation, and levels of ethnic and racial diversity are key determinants of the size and scope of Latin America’s social policy regimes.

Boosting paychecks: the politics of supporting America's working poor

When most people think of policies designed to help the poor, welfare is the first program that comes to mind. Traditionally welfare has served individuals who do not work --hence much of the stigma that some attach to the program. An equally important strand of American social policy, however, is meant to support low-wage workers and their families. In Boosting Paychecks , Daniel Gitterman illuminates this often neglected part of the American safety net. Gitterman focuses on two sets of policy instruments that have been used to aid the working poor since the early twentieth century: the federal tax code and the minimum wage. The income tax code can be fine-tuned in many ways --through exemptions, deductions, credits, changing tax brackets and rates --to alter the amount of income workers are left with at the end of the day. In addition, it interacts with the minimum wage to determine the economic well-being of many lowincome households. Boosting Paychecks analyzes the partisan politics that have shaped these policies since the New Deal era, with particular attention paid to the past three decades. It also examines the degree to which they have succeeded in lifting low-wage workers and their families out of poverty. Forging a new political bargain that balances labor market flexibility with security for poor working families is one of the most critical challenges facing government today. Boosting Paychecks sheds new light on the scope of this challenge and the political constraints and opportunities policymakers face.

Was government the solution or the problem? The role of the state in the history of American social policy

This article attempts to resolve a contradiction noted by Charles Tilly between my earlier writings on education and later writings on the welfare state. The earlier work on education was critical of governments’ role in constructing bureaucratic school systems that reinforced inequality; the later work on the welfare state argued for the extension of government social provision. This article shows how the contradiction poses a false dichotomy. It then uses history to show how assessments of governments’ role reflect the political context in which they are written but rest on consistent values and priorities. The article emphasizes, as well, the absence of a counter narrative to the political right’s assertion of government policy failure; the truncated and inappropriate use of “state” in much writing on public policies; and the need for historians of policy to develop means of assessing the success or failure of government policies and programs.

Changes in Public Opinion and the American Welfare State

Journal Article Changes in Public Opinion and the American Welfare State Get access Greg M. Shaw Greg M. Shaw GREG M. SHAW is associate professor of political science at Illinois Wesleyan University. His work focuses on the relationship between public opinion and American social policy, particularly welfare programs. He is the author of the forthcoming book The Healthcare Debate (Greenwood Press, 2010). Search for other works by this author on: Oxford Academic Google Scholar Political Science Quarterly, Volume 124, Issue 4, Winter 2009, Pages 627–653, https://doi.org/10.1002/j.1538-165X.2009.tb00661.x Published: 15 February 2013

Editorial Introduction: The International Significance of Latin American Social Policy

Editorial Introduction: The International Significance of Latin American Social Policy

Teaching and Learning Guide for: Resisting the Neo‐liberal Poverty Discourse: On Constructing Deadbeat Dads and Welfare Queens

Teaching and Learning Guide for: Resisting the Neo‐liberal Poverty Discourse: On Constructing Deadbeat Dads and Welfare Queens

Judge Sonia Sotomayor and the New Racism: Getting beyond the Politics of Denial

While many liberals suggest that with the election of Barack Obama to the presidency the United States has become a post-racial society, many conservatives have now taken the opposite position, prompted by the nomination of Judge Sonia Sotomayor to the Supreme Court, that racism is alive and well in the American republic.[1] According to many right-wing pundits and politicians extending from Rush Limbaugh to Tucker Carlson, Judge Sotomayor is a ‘racist’ and a ‘bigot’ because of a largely decontextualized 32-word quotation abstracted from a speech she gave in 2001 in which she stated: ‘I would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn’t lived that life’.[2] Newt Gingrich ignored the broader context in which the quotation appeared, insisting that Sotomayor’s statement was symptomatic of a new type of racism. He exclaimed in Twitter-like fashion, ‘Imagine a judicial nominee said “my experience as a white man makes me better than a Latina woman” new racism is no better than old racism’.[3] All of this saber-rattling rhetoric about the emergence of a new kind of racism suggests rather ironically that whites rather than people of color are the real victims of personal and institutional racism and points to a kind of historical amnesia that not only rewrites the meaning of racism, it also points to a long-standing fear among many conservatives that diversity rather the bigotry is the real threat to democracy. What the relentless attack on Judge Sotomayor suggests is that the public morality of American life and social policy regarding matters of racial justice are increasingly subject to a politics of denial. Denial in this case is not merely about the failure of public memory or the refusal to know, but an active ongoing attempt on the part of many conservatives to rewrite the discourse of race so as to deny its valence as a force for discrimination and exclusion either by translating it as a threat to American culture or relegating it to the language of the private sphere. The idea of race and the conditions of racism have real political effects and eliding them only makes those effects harder to recognize. And yet, the urgency to recognize how language is used to name, organize, order, and categorize matters of race not only has academic value, it also provides a location from which to engage difference and the relationship between the self and the other and between the public and private. In addition, the language of race is important because it strongly affects political and policy agendas as well. One only has to think about the effects of Charles Murray’s book, Losing Ground, on American welfare policies in the 1980s.[4] But language is more than a mode of communication or a symbolic practice that produces real effects, it is also a site of contestation and struggle. The charge that Judge Sotomayor is a racist suggests something about the changing vocabulary about race and racial injustice that has to be both critically understood and politically engaged. In fact, there is something called a new racism and it has been brilliantly explored by a number of writers including David Theo Goldberg, Elizabeth Ansell, Howard Winant, and Manning Marable, among others, though they do not use the term in the same way as conservatives. Unlike the old racism, which defined racial difference in terms of fixed biological categories organized hierarchically, the new racism operates in various guises, proclaiming among other things raceneutrality, asserting culture as a marker of racial difference, or marking race as a private matter. Unlike the crude racism with its biological referents and pseudo-scientific legitimations, buttressing