State discretion in ftderal categorical assistance programs: The case of medicaid

Journal Article (Journal Article)

Categorical assistance programs to date have provided themost common method for transterring public funds from the federal government to states and localities. This study develops a model for a representative voter-taxpayer in which income redistribution is viewed as a public good. The model yields several unambiguous predictions about the effect of selected exogenous variables, including taxpayer income, the number of poor persons in the state, and the federal matching proportion for Medicaid (which varies by state) on the amount the Medicaid program pays doctors per procedure. An alternative view is that Medicaid payments are determined largely by interactions among government bureaucracies, private insurance carriers serving as fiscal agents for Medicaid, and physicians. Explanatory variables consistent with the bureaucratic view are included in some regressions. The most important result is that the federal matching proportion has a substantial impact on generosity of state Medicaid programs. © 1984, Sage Publications. All rights reserved.

Full Text

Duke Authors

Cited Authors

  • Sloan, FA

Published Date

  • January 1, 1984

Published In

Volume / Issue

  • 12 / 3

Start / End Page

  • 321 - 346

Electronic International Standard Serial Number (EISSN)

  • 1552-7530

International Standard Serial Number (ISSN)

  • 1091-1421

Digital Object Identifier (DOI)

  • 10.1177/109114218401200303

Citation Source

  • Scopus