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Quantifies & explains intrastate differences in Medicaid spending in MI, a state with a highly centralized program & few local discretionary decisions. The differences exist because implementation takes place in different organizational & political settings, affecting potential participants' willingness to apply for the programs & the responsiveness of social service workers to their clients. A model to predict generosity & participation in MI counties based on supply, demand, & political factors is developed & tested, focusing on participation & spending in 6 counties to understand differences in organizational, political, & task environments. It is concluded that while these factors are important, recipient behavior -- shaped in large part by the behavior of the social service office bureaucratic leadership & the policy environment of the county -- matters as well. 6, 1 Appendix, 52 References. Adapted from the source document.

Large increases in spending for Medicaid have resulted from rapidly escalating health-care inflation & congressionally mandated expansions in the US at a time when state budgets were already under recession-induced stresses. Additionally, 1991 brought new pressures for Medicaid spending from the courts & closer federal scrutiny & control over revenues used for the program's state "match." It is argued, however, that the Medicaid picture is far from bleak; diversity, innovation, & an emerging state policy role also characterize the program in ways that epitomize the strengths & weaknesses of the US intergovernmental system. 2 Tables. Adapted from the source document.

Although there is a growing literature on policy entrepreneurs and policy enactment, there has been little systematic examination of legislative policy entrepreneurs and the effect of policy entrepreneurship on a legislator's standing. This article identifies policy entrepreneurs in each of three sessions of the North Carolina General Assembly and examines the effect of policy entrepreneurship on legislators' effectiveness as perceived by peers and close observers. It also defines and identifies a second category —policy opportunists — legislators who have not exhibited expertise and persistence necessary for policy entrepreneurship but who are associated with salient issues whose "policy window" has opened. Both policy entrepreneurs and policy opportunists benefit from increases in their standing, but policy entrepreneurs benefit more than their opportunistic peers. The importance of the issue cycle is illustrated in the changing cast of legislative policy entrepreneurs and policy opportunists over the three sessions.

ALTHOUGH THERE IS A GROWING LITERATURE ON POLICY ENTREPRENEURS AND POLICY ENACTMENT, THERE HAS BEEN LITTLE SYSTEMATIC EXAMINATION OF LEGISLATIVE POLICY ENTREPRENEURS AND THE EFFECT OF POLICY ENTREPRENEURSHIP ON A LEGISLATOR'S STANDING. THIS ARTICLE IDENTIFIES POLICY ENTREPRENEURS IN EACH OF THREE SESSIONS OF THE NORTH CAROLINA GENERAL ASSEMBLY AND EXAMINES THE EFFECT OF POLICY ENTREPRENEURSHIP ON LEGISLATORS' EFFECTIVENESS AS PERCEIVED BY PEERS AND CLOSE OBSERVERS. IT ALSO DEFINES AND IDENTIFIES A SECOND CATEGORY--POLICY OPPORTUNISTS--LEGISLATORS WHO HAVE NOT EXHIBITED EXPERTISE AND PERSISTENCE NECESSARY FOR POLICY ENTREPRENEURSHIP BUT WHO ARE ASSOCIATED WITH SALIENT ISSUES WHOSE "POLICY WINDOW" HAS OPENED. BOTH POLICY ENTREPRENEURS AND POLICY OPPORTUNISTS BENEFIT FROM INCREASES IN THEIR STANDING, BUT POLICY ENTREPRENEURS MORE THAN THEIR OPPORTUNISTIC PEERS. THE IMPORTANCE OF THE ISSUE CYCLE IS ILLUSTRATED IN THE CHANGING CAST OF LEGISLATIVE POLICY ENTREPRENEURS AND POLICY OPPORTUNISTS OVER THE THREE SESSIONS.

In its 1993 report, the Winter Commission gave direction to the federal government in the area of health policy and Medicaid: lead, follow, or get out of the way. This article examines how the federal government responded to that advice, specifically asking what has happened in the allocation of responsibility in health policies between 1993 and 2006. In short, unlike the suggestion that there be a better‐defined direction in federal–state policy assignments in health, the ensuing years have resulted in more of the same. The authors examine what has happened, particularly focusing on vertical diffusion—where the states have acted first—and on the role of policy learning in federal decision making. They find little recognition of policy learning in recent federal health laws—even in areas in which state experience was extensive. The federal government is leading in some health policies—but it is leading without learning.

The public has evidenced continuing support for state legislative term limits, while those who most closely observe the impacts of term limits often support their repeal or extension. This article examines this paradox of term limit support among two groups of knowledgeable observers—party chairs and lobbyists in Florida. The findings support the idea that to know term limits is NOT to love them. They also suggest that among these political elites, support for the repeal of term limits is not a matter of self-interest, but rather reflects a concern about the institutional viability of an important state representative body.