Abstract: | Because of the active role assumed by the courts in Medicaidnursing facility reimbursement, and because that role changedover time, federal intervention in this area provides a usefulwindow through which to examine the role of the federal judiciaryin oversight of state health policy making. Findings supportthe proposition that because judicial influence extends beyondprogram outcomes to include the organizational structure andbeliefs of key stakeholder groups, the effects of case decisions,and the statutes under which they are litigation, may be deeperand longer lasting than their usefulness as a litigation tool.Findings also support the proposition that neither the executivenor the judiciary acts in isolation but instead they serve astandem institutions guiding federal oversight of state policymaking. Data for this analysis derive from archival documents,secondary sources, and 101 in-depth interviews. |