Editing Medicaid (section)

== Political influences ==
Several political factors influence the cost and eligibility of tax-funded health care. According to a study conducted by Gideon Lukens, factors significantly affecting eligibility included "party control, the ideology of state citizens, the prevalence of women in legislatures, the line-item veto, and physician interest group size." Lukens' study supported the generalized hypothesis that [[Democratic Party (United States)|Democrats]] favor generous eligibility policies while [[Republican Party (United States)|Republicans]] do not.<ref>{{cite journal |last1=Lukens |first1=G. |date=23 September 2014 |title=State Variation in Health Care Spending and the Politics of State Medicaid Policy |journal=Journal of Health Politics, Policy and Law |volume=39 |issue=6 |pages=1213–1251 |doi=10.1215/03616878-2822634 |pmid=25248962}}</ref> When the Supreme Court allowed states to decide whether to expand Medicaid or not in 2012, northern states, in which Democratic legislators predominated, disproportionately did so, often also extending existing eligibility.<ref name=":11">{{cite journal |last1=Rose |first1=Shanna |date=1 January 2015 |title=Opting In, Opting Out: The Politics of State Medicaid Expansion |journal=The Forum |volume=13 |issue=1 |pages=63–82 |doi=10.1515/for-2015-0011 |s2cid=147364036}}</ref>

Certain states in which there is a Republican-controlled legislature may be forced to expand Medicaid in ways extending beyond increasing existing eligibility in the form of waivers for certain Medicaid requirements so long as they follow certain objectives. In its implementation, this has meant using Medicaid funds to pay for low-income citizens' health insurance; this private-option was originally carried out in Arkansas but was adopted by other Republican-led states.<ref name=":11" /> However, private coverage is more expensive than Medicaid and the states would not have to contribute as much to the cost of private coverage.<ref>{{cite journal |last1=Zaloshnja |first1=Eduard |last2=Miller |first2=Ted R. |last3=Coben |first3=Jeffrey |last4=Steiner |first4=Claudia |date=June 2012 |title=How Often Do Catastrophic Injury Victims Become Medicaid Recipients? |journal=Medical Care |volume=50 |issue=6 |pages=513–519 |doi=10.1097/MLR.0b013e318245a686 |jstor=23216705 |pmid=22270099 |s2cid=33723607}}</ref>

Certain groups of people, such as migrants, face more barriers to health care than others due to factors besides policy, such as status, transportation and knowledge of the healthcare system (including eligibility).<ref>{{cite journal |last1=Mojtabai |first1=Ramin |last2=Feder |first2=Kenneth A. |last3=Kealhofer |first3=Marc |last4=Krawczyk |first4=Noa |last5=Storr |first5=Carla |last6=Tormohlen |first6=Kayla N. |last7=Young |first7=Andrea S. |last8=Olfson |first8=Mark |last9=Crum |first9=Rosa M. |date=June 2018 |title=State variations in Medicaid enrollment and utilization of substance use services: Results from a National Longitudinal Study |journal=Journal of Substance Abuse Treatment |volume=89 |pages=75–86 |doi=10.1016/j.jsat.2018.04.002 |pmc=5964257 |pmid=29706176}}</ref>