Master of Arts, Miami University, 2019, Economics

Medicare and Medicaid are U.S. Federal health insurance programs established in 1965 as an amendment to the Social Security Act of 1935. They provide coverage to the aged population (65+), low-income individuals, and to other subsets of the U.S. population. After reviewing the foundations of Medicare/Medicaid, I analyze the political economy of Members of Congress vote choices on the original 1965 Medicare/Medicaid law. I find evidence that the number of doctors per 100,000 individuals in a state is a strong predictor of vote choice and there is statistically significant interaction between percentage of Black Americans and the South. Moreover, there is evidence to suggest that party alignment of constituencies and geographic region played roles in persuading Republicans in party-contested states to defect. The behavior of these defectors is dependent on their party alignment and the party alignment of the majority in Congress. To assess the strength of the model across time and legislation, I run a fully interacted, pooled OLS regression on both the 1965 legislation, and the Medicare Modernization Act of 2003. I find the effects of hospitals do not hold across time. However, I find evidence target populations remain insignificant in both datasets, suggesting they are not strong influencers of vote choice.

Committee: Melissa Thomasson (Advisor); Gregory Niemesh (Committee Member); Deborah Fletcher (Committee Member) Subjects: Economic History; Economics; Health Care; Political Science; Public Policy