Immigrant Health Care Access and the Affordable Care Act

In spite of major coverage expansions under the Patient Protection and Affordable Care Act (ACA), a large proportion of immigrants will continue to remain outside the scope of coverage. Because various provisions of the ACA seek to enhance access, advancing knowledge about immigrant access to health care is necessary. The authors apply the well‐known Andersen model on health care access to two measures—one focusing on perceptions of unmet health care needs and the other on physician visits during the last year. Using data from the New Jersey Family Health Survey, the authors find that prior to implementation of the ACA coverage expansions, immigrants in New Jersey reported lower levels of unmet health care needs despite poorer self‐rated health compared with U.S.‐born residents. The article concludes with a discussion of the use of Andersen model for studying immigrant health care access and the broader implications of the findings.     

Expanding dependent coverage for young adults: lessons from state initiatives

The Patient Protection and Affordable Care Act (ACA) requires that adults up to age twenty-six be permitted to enroll as dependents on their parents' health plans. This article examines the experiences of states that enacted dependent expansion laws. Drawing on public information from thirty-one enacting states and case studies of four diverse reform states, it derives lessons that are pertinent to the implementation of this ACA provision. Dependent coverage laws vary across the states, but most impose residency, marital status, and other restrictions. The federal Employee Retirement Income Security Act further limits the reach of state laws. Eligibility for expanded coverage under the ACA is much broader. Rules in some states requiring or allowing separate premiums for adult dependents may also discourage enrollment compared with rules in other states (and the ACA), where these costs must be factored into family premiums. Business opposition in some states led to more restrictive regulations, especially for how premiums are charged, which in turn raised greater implementation challenges. Case study states did not report substantial young adult dependent coverage take-up, but early enrollment experience under ACA appears to be more positive. Long-term questions remain about the implications of this policy for risk pooling and the distribution of premium costs.     

Viewpoint Discrimination in the Military's Filmmaker Assistance Program and the First Amendment

The U.S. military provides assistance to filmmakers in the form of use of military sites, equipment and personnel, which can provide significant cost savings to filmmakers. The military, however, routinely denies this assistance to filmmakers whose productions portray the military in a way it considers objectionable, actions that constitute viewpoint discrimination by the government. While this may seem to be an unconstitutional violation of First Amendment rights, application of forum law and the unconstitutional conditions doctrine lead to the conclusion that the military's viewpoint discrimination is permissible and does not violate the First Amendment.     

Sharing Isn't Easy: When Separate Institutions Clash

There is a lively debate in the United States about how the president and Congress do and ought to relate, and about the significance of recent clashes between the two over control of the bureaucracy. This article focuses on the causes and consequences of increased congressional (and presidential) review and specification of administrative behavior. It examines congressional oversight behavior, micromanagement by Congress, struggles over control of regulations and interpretations of statutes, and efforts by the White House to increase its control over appointments to executive positions. The article concludes with an overview of the sources of tension between the two institutions and an analysis of the conditions under which they could more successfully share power.     

State Power and Ideology in Britain: Mrs Thatcher's Privatization Programme

State-centred theory, a leading exemplar of the new institutionalism, assumes the separation of state from society and objectivity from subjectivity. This epistemological stance supports a structural analysis which holds that the state is an actor in its own right, that the state has distinctive interests, and that state capacity depends on strong institutions and weak societal opposition. Yet the case of the Thatcher governments'ideologically motivated privatization programme challenges the statists'hypotheses and epistemology. Rather, the making of British privatization policy supports the view that the way political actors form and use ideas is important in explaining state power and in defending the liberal democratic vision of mankind as the maker of history.