Universal health care was on the national political agenda for nearly a hundred years until a comprehensive (but not universal) health care reform bill supported by President Obama passed in 2010. The most common explanation for the failure of past reform efforts is that special interests were continually able to block reform by lobbying lawmakers. Yet, beginning in the 1970s, accelerating with the failure of the Clinton health care plan, and continuing through the passage of the Affordable Care Act in 2010, health policy reform was alive and well at the state level.

Interest Groups and Health Care Reform across the United States assesses the impact of interest groups to determine if collectively they are capable of shaping policy in their own interests or whether they influence policy only at the margins. What can this tell us about the true power of interest groups in this policy arena? The fact that state governments took action in health policy in spite of opposing interests, where the national government could not, offers a compelling puzzle that will be of special interest to scholars and students of public policy, health policy, and state politics.

Virginia Gray is Robert Watson Winston Distinguished Professor of Political Science, University of North Carolina, Chapel Hill.

David Lowery is Bruce R. Miller and Dean D. LaVigne Professor of Political Science at Pennsylvania State University

Jennifer K. Benz serves as a senior research scientist for NORC at the University of Chicago.

Preface and Acknowledgments

Introduction: Interests and Health Policy

1. Health Care and Organized Interests in the United States

2. The Theory and Structure of Health Interest Communities in the States

3. State Pharmacy Assistance Programs as Innovations

4. The Politics of Managing Managed Care

5. Universal Health Care in the States

6. Conclusion: Lessons Learned and Opportunities for Influence in the ACA Policy Environment

Appendix 2.1: Descriptions of Health Interest Organization Subguilds

Appendix 2.2: States Ranked by Health Interest Group Density

Appendix 2.3: Density by Subguild, Raw Numbers in 1998

Appendix 2.4: Data Source for Political Action Committes

Appendix 3.1: List of Data Sources

Appendix 3.2: Estimation of Annual Interest Group Measures Using the ESA Model

Appendix 4.1: Data Sources of Dependent Variables

Appendix 4.2: Managed Care Regulation Descriptive Statistics

Appendix 4.3: Definitions and Sources of Independent Variables

Appendix 5.1: Sources of Dependent Variables

Appendix 5.2: Sources of Independent Variables

References

Index