SAGE Journal Articles
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Abstract: Often described in such terms as a “revolution” and a “game-changer” for the behavioral health sector in the United States, the Affordable Care Act has helped to enhance coverage for mental health and substance use disorders while encouraging service system innovations at the organizational level. However, tens of millions of Americans still lack health insurance, insurance companies are resisting the implementation of parity coverage rules, and inequalities in the financing and organization of care continue to worsen in key respects. This article examines these difficulties and their political-economic nature, highlighting the need for a single-payer framework if the task of reform is to be fulfilled.
Abstract: How does racial diversity affect public policy outcomes in the states? The policy backlash hypothesis suggests that the presence of blacks increases antagonistic attitudes toward minorities among whites and thus produces racially conservative policies. The electoral constraint hypothesis argues that the presence of blacks increases the size of population that supports policy liberalism and thus results in more liberal policies. The authors reconcile these competing explanations by arguing that the hypothesized negative impact of minority group size on policy liberalism varies across states in accordance with socioeconomic and institutional conditions that strengthen or weaken the impacts of electoral constraint or backlash.