Congratulations, PAM PhD candidate, Emily Parker, this year’s recipient of the Association of Public Policy and Management’s best comparative policy paper! Her paper focuses on the political evolution of health policies for the poor (details below).
Title: The Market-Failure Paradox: Political Contention in the U.S. Welfare State
Abstract: Although policies targeting the poor have historically encountered partisan opposition in the United States, political backlash is not inevitable. How do policies for the poor avoid political contention? This study leverages the presence of political contention within Medicaid, the federal-state health insurance program for the poor, and its absence in the Community Health Center (CHC) program, an expansive federally funded network of clinics targeting underserved communities. Drawing upon more than 15,000 primary documents collected from seven presidential archives (1965-2001), I find that initial policy design fundamentally constrained both discursive opportunities as well as the acquisition of political support. The articulation of frames aligning with both markets and morality allowed the CHC program to resonate across ideological divides, whereas Medicaid’s lack of market alignment and pervasive framing as inequitable inhibited its political appeal. Developing a concept of the market failure paradox, I argue that framing antipoverty policies as correcting for market failures subverts contestations over deservingness and is a key component in the evasion of political conflict in the U.S. policymaking process.