Andrea Louise Campbell

Self-Interest, Social Security, and the Distinctive Participation Patterns of Senior Citizens

Decades of participation research show that political activity increases with income, but the participation of senior citizens specifically with regard to Social Security poses an exception to this pattern. Social Security-oriented participation decreases as income rises, in part because lower-income seniors are more dependent on the program. The negative income-participation gradient is especially pronounced for letter writing about the program, but even Social Security-related voting and contributing are less common among higher-income seniors. This is an instance in which self-interest is highly influential: Those who are more dependent are more active. It is also an example of lower-class mobilization with regard to an economic issue, something quite unusual in the United States.

PARTICIPATORY REACTIONS TO POLICY THREATS: Senior Citizens and the Defense of Social Security and Medicare

The sociodemographic factors emphasized in much participation research cannot explain abrupt changes in levels of activity. This study shows how threat of undesirable policy change acts as an impetus to participatory activity, helping to explain temporal variation in participation. Newly available individual-level time-series data are used to show surges in senior citizen letter writing in response to threats to Social Security and Medicare during the 1980s. Policy threat interacts with individual characteristics to produce variations in participatory reaction congruent with the magnitude of the threat to the individual.

Federalism and the Politics of Old-Age Care in Germany and the United States:

Until the early 1990s, Germany and the United States had similar systems of long-term care. At that time, Germany created a new social insurance program, whereas American reform efforts stalled. As conventional explanations of social policies—rooted in objective conditions, policy legacies, interest group mobilization, and party politics—fail to explain the diverging trajectories, the authors show how differing federal structures shaped reform efforts. German federalism gives states a strong voice and encourages collective responses to fiscal problems, enabling comprehensive restructuring of long-term care financing. In the United States, states lack a political mechanism to compel federal policy makers to tackle this subject. This analysis suggests reform of social welfare issues with weakly mobilized publics is unlikely without proxy actors that have institutional or political means to forcibly gain the attention of policy makers. In addition, scholars should pay more attention to “varieties of federalism” in analyses of the welfare state.

Financing the Welfare State: Elite Politics and the Decline of the Social Insurance Model in America

fits and services provided by the welfare state, few scholars have investigated how these programs are financed. The tax side of the budget equation is crucial for the ability of welfare states to exist and expand; without a stable and growing source of revenues, the welfare state can neither meet its existing obligations nor increase its responsibilities. The mode of finance can be particularly important, as some taxes are more visible or contested, and thus more difficult to raise. For example, because there are limits to how much revenue can be raised with progressive income taxes, many industrialized countries finance large social programs through contributory finance, that is, payroll taxes. Levied over a broad swath of the population, these taxes generate a large amount of revenue, yet are politically acceptable because people see them as payments that entitle them to benefits in return. Payroll taxes are central to the American social insurance model, financing two of the most significant government programs in American history: Social Security and Medicare. Since its passage in 1935, Social Security has alleviated much senior poverty, while Medicare provides access to healthcare for a population often lacking insurance. As universal entitlements, both programs are enormously popular with the public, and have enjoyed support even through times of fiscal difficulty and rising antitax sentiment. Despite the economic and political success of these programs, policy-makers have turned away from the social insurance model in recent decades, arguing that a limit has been reached in the public’s willingness to pay these taxes. As a result, the existing programs have not been put on stable long-term footing. Moreover, proposed expansions of the welfare state, including improvements in Medicare, long-term care coverage, and access to health insurance for the uninsured, have foundered, in large measure owing to their lack of financing.1 Why have elites rejected this highly successful mode of financing social policy? Why have they turned their backs on payroll tax funding, especially when the average citizen appears willing to pay higher payroll taxes, when American tax rates are still Studies in American Political Development, 19 (Fall 2005), 173–195.

State Fiscal Policy during the Great Recession Budgetary Impacts and Policy Responses

Plunging tax revenues and soaring social program demand during the Great Recession created state budget shortfalls of historic magnitude. After reviewing states’ aggregate reaction to the economic downturn, we conduct an original analysis of the recession’s budgetary impact on the states and their policy responses. Economic factors such as falling personal income and home values explain much of the variation in the recession’s impact. State budgeting rules and practices conditioned states’ experiences, but not always as intended: budget gaps were smaller in states with stricter balanced budget requirements, but larger in states with statutory spending limitations. Personal income tax increases were more likely in states with a Democratic legislature or greater public unionization rates, while midyear spending cuts were smaller in states with larger public sector unions. In sum, we find that while states’ objective economic situations determined the bulk of their responses to the Great Recession, political factors determined these responses’ shape and form.

The Public’s Role in Winner-Take-All Politics

Jacob Hacker and Paul Pierson argue here and elsewhere that political science needs to return seriously to the study of policy. They assert that the rise of the behavioralist and rational choice strands of inquiry have led to an emphasis on elections as the central phenomenon of interest, but that policy is what really matters, both to politicians and to societal outcomes. Their essay in this volume does indeed forcefully demonstrate the profound effects of policy on society, here the extraordinary growth in economic inequality in the United States in recent decades. And yet while this return to policy-centered analysis would both bring political science back to its roots and lay bare a number of momentously consequential changes in the polity, there is still much to learn from these other approaches. It is undoubtedly important to study organized groups and the activities in which they engage. However, it is just as important to understand the limitations of ordinary citizens as political actors and the resulting ability of organized groups to do such an effective end run around them. Hence I do not dispute Hacker and Pierson’s findings but rather argue that their account would be enriched with an appreciation not just for organized interests’ rise but also the failings of citizens to act as an effective counterweight.

A Partisan Divide On The Uninsured

The partisan split in Congress over health reform may reflect a broader divide among the public in attitudes toward the uninsured. Despite expert consensus over the harms suffered by the uninsured as a group, Americans disagree over whether the uninsured get the care they need and whether reform legislation providing universal coverage is necessary. We examined public perceptions of health care access and quality for the uninsured over time, and we found that Democrats are far more likely than Republicans to believe that the uninsured have difficulty gaining access to care. Senior citizens are less aware than others of the problems faced by the uninsured. Even among those Americans who perceive that the uninsured have poor access to care, Republicans are significantly less likely than Democrats to support reform. Thus, our findings indicate that even if political obstacles are overcome and health reform is enacted, future political support for ongoing financing to cover the uninsured could be uncertain.

JHPPL Workshop on Medicaid Fiscal and Governance Issues: Objectives and Themes

At a November 2012 workshop, state health policy officials, other Medicaid and insurance exchange practitioners, and health policy researchers discussed issues surrounding the implementation and sustainability of Medicaid expansion and insurance exchange coordination under the Patient Protection and Affordable Care Act (PPACA). Foremost were concerns about (1) intergovernmental relations (states experiencing uncertain information, lack of coordination among federal agencies, and limited resources to take on new responsibilities under the PPACA), and (2) policy design (new issues such as Medicaid exchange coordination on top of preexisting Medicaid challenges). JHPPL has proposed the creation of a research network to develop policy options and share strategies and best practices.