Leiden University Student Repository

Ashmead, Carlijn 2022

The Affordable Care Act in Low-income U.S. States: A comparative analysis of Louisiana and Mississippi

Master thesis | International Relations (MA)

open access

The United States has a high level of uninsured citizens. Through the Affordable Care Act (ACA) the federal government has provided funding and a set of rules for Medicaid, to increase the level of...Show moreThe United States has a high level of uninsured citizens. Through the Affordable Care Act (ACA) the federal government has provided funding and a set of rules for Medicaid, to increase the level of uninsured citizens. In the low-income states Louisiana and Mississippi, the uninsured rate has been high for decades. The ACA is not a mandatory act to implement in a state, which results in the ability of states such as Mississippi to reject implementation. In this thesis, factors of influence have been researched what drives state governments to not implement the full ACA. Through the usage of official governmental documents and local newspapers, the outcome of factors of influence can be allocated to political/ideological factors, economic factors and public opinion. Secondly, the comparative effect of the ACA has been measured in order to conclude if it matters to implement the Medicaid expansion in the low-income states. Through the comparing of data on uninsured rates and the costs of Medicaid, the results are that Medicaid is more expensive for the state government of LA, but does decrease the uninsured rate significantly. Whereas in Mississippi Medicaid is less expensive for the state government, the uninsured rate remains higher than the national average. Therefore, a trade-off has to be made between accessibility of healthcare and more economic burden for the low-income states.Show less