Federalism and the safety net: Delinkage and participation rates

Publius

Volumn 30, Issue 1, 2000, Pages 119-141

  Thompson, Frank J ^a   Gais, Thomas L ^a  

^a STATE UNIVERSITY OF NEW YORK   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 0040516119     PISSN: 00485950     EISSN: None     Source Type: Journal    
DOI: 10.1093/oxfordjournals.pubjof.a030056     Document Type: Article

References (80)

1. See, for instance, Barbara J. Nelson, "Help-Seeking From Public Authorities: Who Arrives at the Agency Door?" Policy Sciences 12 (1980): 175-192; Joe Soss, "Lessons of Welfare: Policy Design, Political Learning, and Political Action," American Political Science Review 93 (June 1999): 363-380.
2. See, for instance, Barbara J. Nelson, "Help-Seeking From Public Authorities: Who Arrives at the Agency Door?" Policy Sciences 12 (1980): 175-192; Joe Soss, "Lessons of Welfare: Policy Design, Political Learning, and Political Action," American Political Science Review 93 (June 1999): 363-380.
3. By the end of the decade, the caseload had declined so much in five states (Indiana, Oklahoma, Oregon, Wisconsin, and Wyoming) that the mandatory work requirements for recipients did not apply. Robert Pear, "White House Releases New Figures On Welfare," New York Times, 1 August 1999, p. 16.
4. Richard P. Nathan and Thomas L. Gais, Implementing the Personal Responsibility Act of 1996: A First Look (Albany, NY: Rockefeller Institute of Government, 1999), p. 35; see also Carol S. Weissert, "Beyond the Organization: The Influence of Community and Personal Values on Street-Level Bureaucrats' Responsiveness," Journal of Public Administration Research and Theory 4 (1994): 225-254.
5. Richard P. Nathan and Thomas L. Gais, Implementing the Personal Responsibility Act of 1996: A First Look (Albany, NY: Rockefeller Institute of Government, 1999), p. 35; see also Carol S. Weissert, "Beyond the Organization: The Influence of Community and Personal Values on Street-Level Bureaucrats' Responsiveness," Journal of Public Administration Research and Theory 4 (1994): 225-254.
6. Nathan and Gais, Implementing, pp. 5-8.
7. See Kathleen A. Maloy et al., A Description of The State Approaches to Diversion Programs and Activities (Washington, DC: George Washington University, 1998); Marcia K. Meyers, Norma M. Riccucci, and Irene Lurie, "Achieving Goal Congruence in Complex Environments: The Case of Welfare Reform," (Paper presented at the Fifth National Public Management Research Conference, College Station, Texas, 1999).
8. See Kathleen A. Maloy et al., A Description of The State Approaches to Diversion Programs and Activities (Washington, DC: George Washington University, 1998); Marcia K. Meyers, Norma M. Riccucci, and Irene Lurie, "Achieving Goal Congruence in Complex Environments: The Case of Welfare Reform," (Paper presented at the Fifth National Public Management Research Conference, College Station, Texas, 1999).
9. The Administration for Children and Families, U.S. Department of Health and Human Services, U.S. Welfare Caseloads Information, September 1999 Caseload Numbers, June 2000; http://www.acf.dhhs.gov/ news/tables.htm.
10. U.S. Health Care Financing Administration, 12 June 2000; http://www.hcfa.gov/init/enroll99.pfd. These general eligibility criteria tell only part of the story because states also have discretion to apply earnings disregards to applicants. This action may effectively increase the income families can earn while still remaining qualified for Medicaid and CHIP.
11. Robert Pear, "Clinton Ordering Effort To Sign Up Medicaid Children," New York Times, 29 December 1997, p. A1.
12. U.S. Department of Health and Human Services, Report to the President: Interagency Task Force on Children's Health Insurance Outreach (Washington, DC: 1998).
13. Robert Wood Johnson Foundation, http://www.rwjf.org/library/2000issue1/index.htm, 12 June 2000.
14. U.S. Department of Health and Human Services, Supporting Families in Transition: A Guide To Expanding Health Coverage in the Post-Welfare Reform World (Washington, DC: 1999).
15. Judith Moore, Personal Correspondence, 8 April 1999.
16. Robert Pear, "Clinton To Chide States For Failing To Cover Children," New York Times, 8 August 1999, pp. 1, 27; see also Raymond Hernandez, "Inquiry Grows As Rolls Fall For Medicaid," New York Times, 8 June 1999, p. B1.
17. Robert Pear, "Clinton To Chide States For Failing To Cover Children," New York Times, 8 August 1999, pp. 1, 27; see also Raymond Hernandez, "Inquiry Grows As Rolls Fall For Medicaid," New York Times, 8 June 1999, p. B1.
18. Title VII, Section 702 of the Medicare, Medicaid and SCHIP Refinement Act of 1999.
19. The limits to the data base needed to produce accurate estimates of enrollments and take-up rates receive attention later in this article. For present purposes, it deserves emphasis that the basic task of tracking Medicaid enrollments nationally let alone on a state-by-state basis poses difficulties. Problems with the accuracy of the data persist. See, for instance, U.S. General Accounting Office, Medicaid Enrollment: Amid Declines, State Efforts to Ensure Coverage After Welfare Reform Vary (Washington, DC: GAO/HEHS-99-163, 1999), pp. 42-43. Even astute analysts who seek to compensate for errors in HCFA data can reach markedly different conclusions in tracking enrollments. The General Accounting Office report cited immediately above concluded that enrollment of nondisabled women and children had declined by 13 percent from 1995 to 1997 in Oregon; another careful analysis conducted by the Urban Institute concluded that Oregon's enrollments for this group had increased by close to 30 percent over the same period. See Leighton Ku and Brian Bruen, "The Continuing Decline in Medicaid Coverage" (Washington, DC: Urban Institute, December 1999) p. 4. In general, however, the findings of Leighton and Bruen converge with those of the General Accounting Office. Timeliness is also a problem with HCFA data. As of mid-June 2000, for instance, the agency had still not released data on enrollments for 1998.
20. The limits to the data base needed to produce accurate estimates of enrollments and take-up rates receive attention later in this article. For present purposes, it deserves emphasis that the basic task of tracking Medicaid enrollments nationally let alone on a state-by-state basis poses difficulties. Problems with the accuracy of the data persist. See, for instance, U.S. General Accounting Office, Medicaid Enrollment: Amid Declines, State Efforts to Ensure Coverage After Welfare Reform Vary (Washington, DC: GAO/HEHS-99-163, 1999), pp. 42-43. Even astute analysts who seek to compensate for errors in HCFA data can reach markedly different conclusions in tracking enrollments. The General Accounting Office report cited immediately above concluded that enrollment of nondisabled women and children had declined by 13 percent from 1995 to 1997 in Oregon; another careful analysis conducted by the Urban Institute concluded that Oregon's enrollments for this group had increased by close to 30 percent over the same period. See Leighton Ku and Brian Bruen, "The Continuing Decline in Medicaid Coverage" (Washington, DC: Urban Institute, December 1999) p. 4. In general, however, the findings of Leighton and Bruen converge with those of the General Accounting Office. Timeliness is also a problem with HCFA data. As of mid-June 2000, for instance, the agency had still not released data on enrollments for 1998.
21. See U.S. General Accounting Office, Medicaid Enrollments, p. 10; this analysis excluded Rhode Island and West Virginia because researchers were unable to obtain comparable enrollment data for 1995 and 1997 in these two cases. Using a different method, Ku and Bruen included both of these missing states in their analysis and concluded that enrollments had declined in each. They estimated enrollment drop-offs in West Virginia to be the largest in the country at 21 percent; " The Continuing Decline in Medicaid Coverage," p. 4.
22. See U.S. General Accounting Office, Medicaid Enrollments, p. 10; this analysis excluded Rhode Island and West Virginia because researchers were unable to obtain comparable enrollment data for 1995 and 1997 in these two cases. Using a different method, Ku and Bruen included both of these missing states in their analysis and concluded that enrollments had declined in each. They estimated enrollment drop-offs in West Virginia to be the largest in the country at 21 percent; " The Continuing Decline in Medicaid Coverage," p. 4.
23. Victoria Pulos, One Step Forward, One Step Back: Children's Health Coverage After CHIP and Welfare Reform (Washington, DC: Families USA, 1999).
24. Thomas M. Selden, Jessica S. Banthin, and Joel W. Cohen, "Medicaid's Problem Children: Eligible But Not Enrolled," Health Affairs 17 (May/June 1998): 192-200, and "Waiting In The Wings: Eligibility and Enrollment in the State Children's Health Insurance Program," Health Affairs 18 (March/April 1999): 126-133; see also U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, "Understanding Estimates of Uninsured Children: Putting the Differences in Context2E" (1999) http://www.aspe.os.dhhs.gov/rn/rn21.htm. Data from the 1997 National Survey of American Families conducted by the Urban Institute estimated that 9.2 million children under age 19 lacked health insurance. Seventy-seven percent of these children were in families with incomes below 200 percent of the poverty line. See Ruth A. Almeida and Genevieve M. Kenney, "Gaps in Insurance Coverage for Children: A Pre-CHIP Baseline" (Washington, DC: Urban Institute, 2000), p. 1.
25. Thomas M. Selden, Jessica S. Banthin, and Joel W. Cohen, "Medicaid's Problem Children: Eligible But Not Enrolled," Health Affairs 17 (May/June 1998): 192-200, and "Waiting In The Wings: Eligibility and Enrollment in the State Children's Health Insurance Program," Health Affairs 18 (March/April 1999): 126-133; see also U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, "Understanding Estimates of Uninsured Children: Putting the Differences in Context2E" (1999) http://www.aspe.os.dhhs.gov/rn/rn21.htm. Data from the 1997 National Survey of American Families conducted by the Urban Institute estimated that 9.2 million children under age 19 lacked health insurance. Seventy-seven percent of these children were in families with incomes below 200 percent of the poverty line. See Ruth A. Almeida and Genevieve M. Kenney, "Gaps in Insurance Coverage for Children: A Pre-CHIP Baseline" (Washington, DC: Urban Institute, 2000), p. 1.
26. Thomas M. Selden, Jessica S. Banthin, and Joel W. Cohen, "Medicaid's Problem Children: Eligible But Not Enrolled," Health Affairs 17 (May/June 1998): 192-200, and "Waiting In The Wings: Eligibility and Enrollment in the State Children's Health Insurance Program," Health Affairs 18 (March/April 1999): 126-133; see also U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, "Understanding Estimates of Uninsured Children: Putting the Differences in Context2E" (1999) http://www.aspe.os.dhhs.gov/rn/rn21.htm. Data from the 1997 National Survey of American Families conducted by the Urban Institute estimated that 9.2 million children under age 19 lacked health insurance. Seventy-seven percent of these children were in families with incomes below 200 percent of the poverty line. See Ruth A. Almeida and Genevieve M. Kenney, "Gaps in Insurance Coverage for Children: A Pre-CHIP Baseline" (Washington, DC: Urban Institute, 2000), p. 1.
27. Thomas M. Selden, Jessica S. Banthin, and Joel W. Cohen, "Medicaid's Problem Children: Eligible But Not Enrolled," Health Affairs 17 (May/June 1998): 192-200, and "Waiting In The Wings: Eligibility and Enrollment in the State Children's Health Insurance Program," Health Affairs 18 (March/April 1999): 126-133; see also U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, "Understanding Estimates of Uninsured Children: Putting the Differences in Context2E" (1999) http://www.aspe.os.dhhs.gov/rn/rn21.htm. Data from the 1997 National Survey of American Families conducted by the Urban Institute estimated that 9.2 million children under age 19 lacked health insurance. Seventy-seven percent of these children were in families with incomes below 200 percent of the poverty line. See Ruth A. Almeida and Genevieve M. Kenney, "Gaps in Insurance Coverage for Children: A Pre-CHIP Baseline" (Washington, DC: Urban Institute, 2000), p. 1.
28. U.S. General Accounting Office, Medicaid Enrollment, p. 25.
29. U.S. General Accounting Office, Food Stamp Program: Various Factors Have Led To Declining Participation (Washington, DC: GAO/RCED-99-185, 1999).
30. Victoria Wegener, "Food Stamp Education and Outreach Working to Provide Nutrition Benefits to Eligible Households," Welfare Information Network Information Note 3, December 1999; http:// www.welfareinfo.org/foodstampout.htm.
31. U.S. General Accounting Office, Food Stamp Program.
32. Ibid.; Laura Castner and Scott Cody, "Trends in FSP Participation Rates: Focus on September, 1997" (Washington, DC: Mathematica Policy Research Inc., 1999); data on Food Stamp household participation by state were obtained from the Food and Nutrition Service of the U.S. Department of Agriculture.
33. Ibid.; Laura Castner and Scott Cody, "Trends in FSP Participation Rates: Focus on September, 1997" (Washington, DC: Mathematica Policy Research Inc., 1999); data on Food Stamp household participation by state were obtained from the Food and Nutrition Service of the U.S. Department of Agriculture.
34. See U.S. Department of Agriculture, Food and Nutrition Service, "Who Is Leaving the Food Stamp Program: An Analysis of Caseload Changes from 1994 to 1997," FNS Online, http://www.fns.usda.gov/ fin/menu/published/fsp/FILES/CDR.html (1999), and Geoffrey Wallace and Rebecca M. Blank, "What Goes Up Must Come Down? Explaining Recent Changes in Public Assistance Caseloads," Economic Conditions and Welfare Reform, ed. Sheldon H. Danziger (Kalamazoo, MI: W.E. Upjohn Institute, 1999).
35. See U.S. Department of Agriculture, Food and Nutrition Service, "Who Is Leaving the Food Stamp Program: An Analysis of Caseload Changes from 1994 to 1997," FNS Online, http://www.fns.usda.gov/ fin/menu/published/fsp/FILES/CDR.html (1999), and Geoffrey Wallace and Rebecca M. Blank, "What Goes Up Must Come Down? Explaining Recent Changes in Public Assistance Caseloads," Economic Conditions and Welfare Reform, ed. Sheldon H. Danziger (Kalamazoo, MI: W.E. Upjohn Institute, 1999).
36. Castner and Cody, "Trends In FSP Participation Rates;" Sheila R. Zedlewski and Sarah Brauner, "Are The Steep Declines in Food Stamp Participation Linked to Falling Welfare Caseloads?" (Washington, DC: Urban Institute, November 1999); see also M. Robin Dion and LaDonna Pavetti, Access to and Participation in Medicaid and the Food Stamp Program: A Review of the Recent Literature (Washington, DC: Mathematica Policy Research, Inc., 2000).
37. Castner and Cody, "Trends In FSP Participation Rates;" Sheila R. Zedlewski and Sarah Brauner, "Are The Steep Declines in Food Stamp Participation Linked to Falling Welfare Caseloads?" (Washington, DC: Urban Institute, November 1999); see also M. Robin Dion and LaDonna Pavetti, Access to and Participation in Medicaid and the Food Stamp Program: A Review of the Recent Literature (Washington, DC: Mathematica Policy Research, Inc., 2000).
38. Castner and Cody, "Trends In FSP Participation Rates;" Sheila R. Zedlewski and Sarah Brauner, "Are The Steep Declines in Food Stamp Participation Linked to Falling Welfare Caseloads?" (Washington, DC: Urban Institute, November 1999); see also M. Robin Dion and LaDonna Pavetti, Access to and Participation in Medicaid and the Food Stamp Program: A Review of the Recent Literature (Washington, DC: Mathematica Policy Research, Inc., 2000).
39. See Frank J. Thompson and Richard P. Nathan, "The Relationship Between Welfare Reform and Medicaid: A Preliminary View." Paper presented at the National Health Policy Forum, Washington, DC, 26 February 1999.
40. Michael Perry et al., Medicaid and Children: Overcoming Barriers to Enrollment (Washington DC: Kaiser Commission on Medicaid and the Uninsured, 2000), pp. 12, 19; U.S. Department of Agriculture, "Customer Service in the Food Stamp Program: Summary of Findings," December 1999; http:// www.fns.usda.gov/oane/MENU/Published/FSP/FILES/sumnfsps1.htm.
41. Michael Perry et al., Medicaid and Children: Overcoming Barriers to Enrollment (Washington DC: Kaiser Commission on Medicaid and the Uninsured, 2000), pp. 12, 19; U.S. Department of Agriculture, "Customer Service in the Food Stamp Program: Summary of Findings," December 1999; http:// www.fns.usda.gov/oane/MENU/Published/FSP/FILES/sumnfsps1.htm.
42. Michael Perry et al., Medicaid and Children: Overcoming Barriers to Enrollment (Washington DC: Kaiser Commission on Medicaid and the Uninsured, 2000), pp. 12, 19; U.S. Department of Agriculture, "Customer Service in the Food Stamp Program: Summary of Findings," December 1999; http:// www.fns.usda.gov/oane/MENU/Published/FSP/FILES/sumnfsps1.htm.
43. Marilyn Ellwood, The Medicaid Eligibility Maze: Coverage Expands But Enrollment Problems Persist (Washington, DC: Urban Institute, 1999).
44. U.S. General Accounting Office, Food Stamp Program, pp. 7, 14.
45. Ellwood, The Medicaid Eligiblity Maze; U.S. General Accounting Office, Medicaid Enrollment, p. 24.
46. Ellwood, The Medicaid Eligiblity Maze; U.S. General Accounting Office, Medicaid Enrollment, p. 24.
47. Sally Richardson, Presentation at the Annual Meeting of the National Academy of Social Insurance, Washington, DC, 28 January 1999.
48. Wegener, "Food Stamp Education and Outreach."
49. U.S. General Accounting Office, Children's Health Insurance Program: State Implementation Approaches are Evolving (Washington, DC: GAO/HEHS-99-65,1999); Robert Pear and Robin Toner, "President Urges Government To Reach Uninsured Children," New York Times, 13 October 1999, p. A16.
50. U.S. General Accounting Office, Children's Health Insurance Program: State Implementation Approaches are Evolving (Washington, DC: GAO/HEHS-99-65,1999); Robert Pear and Robin Toner, "President Urges Government To Reach Uninsured Children," New York Times, 13 October 1999, p. A16.
51. Ellwood, The Medicaid Eligibility Maze, p. 18.
52. U.S. Department of Health and Human Services, Office of Inspector General, The Children's Health Insurance Program (Washington, DC: May 1999), http://www.dhhs.gov/progorg/oei.
53. Thomas L. Gais and Cathy M. Johnson, "Welfare Reform, Management Systems, and Policy Theories of Child Well-Being." Paper presented at a conference sponsored by the Joint Center for Policy Research, Washington, DC: 26 September 1999.
54. See, for example, U.S. General Accounting Office, Children's Health Insurance Program.
55. W. Waldman, Presentation at the National Health Policy Forum, Washington, DC, 26 February 1999.
56. Meyers et al., "Achieving Goal Congruence;" Gais and Johnson, "Welfare Reform."
57. Meyers et al., "Achieving Goal Congruence;" Gais and Johnson, "Welfare Reform."
58. Claudia Schlosberg and Joel D. Ferber, "Access to Medicaid Since the Personal Responsibility and Work Opportunity Reconciliation Act," Clearing House Review 31 (1998): 533.
59. U.S. General Accounting Office, Food Stamp Program, p. 15.
60. Zedlewski and Brauner, "Are the Steep Declines in Food Stamp Participation."
61. See Daphne A. Kenyon and John Kincaid, eds., Competition among States and Local Governments (Washington, DC: Urban Institute, 1991); Sanford F. Schram and Joe Soss, "Making Something Out of Nothing: Welfare Reform and a New Race to the Bottom," Publius: The Journal of Federalism 28 (Summer 1998): 67-88; Frank J. Thompson, "Federalism And The Medicaid Challenge," Medicaid And Devolution: A View From The States, eds. Frank J. Thompson and John J. DiIulio Jr. (Washington, DC: The Brookings Institution, 1998), pp. 258-296; Barry R. Weingast, "The Economic Role of Political Institutions: Market-Preserving Federalism and Economic Development," Journal of Law, Economics & Organization 7 (#1 1995): 1-31.
62. See Daphne A. Kenyon and John Kincaid, eds., Competition among States and Local Governments (Washington, DC: Urban Institute, 1991); Sanford F. Schram and Joe Soss, "Making Something Out of Nothing: Welfare Reform and a New Race to the Bottom," Publius: The Journal of Federalism 28 (Summer 1998): 67-88; Frank J. Thompson, "Federalism And The Medicaid Challenge," Medicaid And Devolution: A View From The States, eds. Frank J. Thompson and John J. DiIulio Jr. (Washington, DC: The Brookings Institution, 1998), pp. 258-296; Barry R. Weingast, "The Economic Role of Political Institutions: Market-Preserving Federalism and Economic Development," Journal of Law, Economics & Organization 7 (#1 1995): 1-31.
63. See Daphne A. Kenyon and John Kincaid, eds., Competition among States and Local Governments (Washington, DC: Urban Institute, 1991); Sanford F. Schram and Joe Soss, "Making Something Out of Nothing: Welfare Reform and a New Race to the Bottom," Publius: The Journal of Federalism 28 (Summer 1998): 67-88; Frank J. Thompson, "Federalism And The Medicaid Challenge," Medicaid And Devolution: A View From The States, eds. Frank J. Thompson and John J. DiIulio Jr. (Washington, DC: The Brookings Institution, 1998), pp. 258-296; Barry R. Weingast, "The Economic Role of Political Institutions: Market-Preserving Federalism and Economic Development," Journal of Law, Economics & Organization 7 (#1 1995): 1-31.
64. See Daphne A. Kenyon and John Kincaid, eds., Competition among States and Local Governments (Washington, DC: Urban Institute, 1991); Sanford F. Schram and Joe Soss, "Making Something Out of Nothing: Welfare Reform and a New Race to the Bottom," Publius: The Journal of Federalism 28 (Summer 1998): 67-88; Frank J. Thompson, "Federalism And The Medicaid Challenge," Medicaid And Devolution: A View From The States, eds. Frank J. Thompson and John J. DiIulio Jr. (Washington, DC: The Brookings Institution, 1998), pp. 258-296; Barry R. Weingast, "The Economic Role of Political Institutions: Market-Preserving Federalism and Economic Development," Journal of Law, Economics & Organization 7 (#1 1995): 1-31.
65. Paul E. Peterson, Barry G. Rabe, Kenneth K. Wong, When Federalism Works (Washington, DC: The Brookings Institution, 1986).
66. The concept of "picket fence federalism" is consistent with this view. This concept posits that administrative alliances between federal and state administrators matter greatly in shaping program delivery, even to a point that accountability to elected officials becomes attenuated. See David B. Walker, Toward A Functioning Federalism (Cambridge, MA: Winthrop, 1981).
67. See, for instance, Donald J. Boyd, "Medicaid Devolution: A Fiscal Perspective," Medicaid and Devolution, eds. Thompson and DiIulio, pp. 56-105.
68. The ten most populous states are California, Texas, New York, Florida, Pennsylvania, Illinois, Ohio, Michigan, New Jersey, and Georgia.
69. See, for instance, Timothy Conlan, from New Federalism to Devolution (Washington, DC: The Brookings Institution, 1998).
70. Robert B. Hackey, Rethinking Health Care Policy (Washington, DC: Georgetown University Press, 1998), p. 50.
71. Thompson, "Federalism and the Medicaid Challenge."
72. Richard P. Nathan, Social Science in Government: Uses and Misuses (New York: Basic Books, 1988), p. 128.
73. Michael S. Sparer and Lawrence D. Brown, "States and the Health Care Crisis: The Limits and Lessons of Laboratory Federalism," Health Policy, Federalism, and the American States, eds. Robert F. Rich and William D. White (Washington, DC: Urban Institute Press, 1996), p. 189.
74. Given that the environment and behavior of local social service offices shape participation rates, it would be optimal to have not only valid and reliable state samples but also samples that foster insight into local factors that help explain intrastate variation.
75. Kimball Lewis, Marilyn Ellwood, and John L. Czajka, Counting the Uninsured: A Review of the Literature (Washington, DC: Urban Institute, 1998); Frank Ullman, Brian Bruen, and John Holahan, The State Children's Health Insurance Program: A Look at the Numbers (Washington, DC: Urban Institute, 1998).
76. Kimball Lewis, Marilyn Ellwood, and John L. Czajka, Counting the Uninsured: A Review of the Literature (Washington, DC: Urban Institute, 1998); Frank Ullman, Brian Bruen, and John Holahan, The State Children's Health Insurance Program: A Look at the Numbers (Washington, DC: Urban Institute, 1998).
77. See Paul Starr, "The Sociology of Official Statistics," The Politics of Numbers, eds. William Alonso and Paul Starr (New York: Russell Sage Foundation, 1987), pp. 7-57.
78. Joel Aberbach, Keeping a Watchful Eye (Washington, DC: The Brookings Institution, 1990).
79. Pear, "Clinton to Chide States for Failing to Cover Children."
80. Title VII, Section 702 of the Medicare, Medicaid, and SCHIP Refinement Act of 1999.