Interstate Spillovers, Fiscal Decentralization, and Public Spending on Medicaid Home- and Community-Based Services

• 成果类型: Article
• 署名作者: Oyun, Gerel
• 署名单位: American University of Sharjah
• 刊物名称: PUBLIC ADMINISTRATION REVIEW
• ISSN/ISSBN: 0033-3352
• DOI: 10.1111/puar.12639
• 发表日期: 2017
• 页码: 566-578
• 关键词: long-term-care; spatial autoregressive model; Government size; state; POLICY; COMPETITION; diffusion; expenditures; performance; FEDERALISM

摘要

This article examines the interstate spillover effect of Medicaid expenditures for home-and community-based services (HCBS) and tests the relationship between fiscal decentralization and public spending. Based on the theory of interstate strategic interaction, an empirical model is specified that explicitly accounts for interdependence in states' spending decisions. The model is estimated by applying spatial econometric methods to panel data for the 50 U.S. states for 2000-2010. Findings show a positive interdependence in state HCBS expenditures that is contingent on similarity in citizen ideology between states. Fiscal decentralization, measured by transfer dependence and revenue autonomy, is positively related to Medicaid HCBS spending.