Not every student’s senior thesis topic is discussed on the nightly news, but when your interest is in state Medicaid expansion under the Affordable Care Act, you’ve got to expect your topic to be fodder for the hopefuls vying to be our next president.
“I first became interested in this project because it tackles one of the most pressing issues facing the American political system today—increasing polarization at both the elite and grassroots levels,” says Larisa Antonisse, a political science major. “This polarization makes it very difficult to get policies through the legislative process, but even the policies that are successfully passed still face formidable opposition during implementation, especially at the state level.”
Antonisse’s thesis, “Overcoming Partisan Opposition to Federal Policy Implementation: The Role of Interest Groups in State Fights to Expand Medicaid,” used Arizona and Virginia as case studies for Medicaid expansion and explored interest group coalition composition and lobbying strategy as potential approaches to overcoming organized opposition to policy implementation. Due to the newsworthiness of her research, her advisor, Associate Professor Steve McGovern, urged to to submit her thesis to the University of Arizona Press to try and get it published as a book. (She hasn’t yet heard back from the publisher.)
“It’s probably a long shot given that it is very rare for undergraduates theses to get published in their entirety,” she says. “[But] my advisor and I think it’s worth a try, though, in this case because of the timeliness of this topic, the general lack of existing research on it, the number of fascinating and important results that I was lucky enough to obtain, and the way my project shines a spotlight on the Arizona case as an excellent model for other states.”
What did you learn from working on your thesis?
Working on my thesis taught me a lot about political polarization, the process of policy implementation, state government politics, the Medicaid program, and the Affordable Care Act. The thesis process also helped me develop research, writing, analytic, and oral presentation skills, which I believe will prove extremely valuable in the future. It is hard for me to pinpoint a single “biggest takeaway,” but I think the part of this project from which I probably learned the most was conducting interviews with 18 prominent interest group leaders, state legislators, and state government officials in Virginia and Arizona. That experience taught me how to gain the trust of my expert sources during the brief interviews and think on my feet to ask the right questions.
What are the implications for your research?
This comparative case study of efforts to expand Medicaid under the Affordable Care Act in two states—Virginia and Arizona—suggests a strategic response to the problem of organized partisan opposition obstructing federal policy implementation. Offering an in-depth look into the inner workings of each state’s Medicaid expansion efforts, this project reveals the critical difference made by the mobilization and advocacy efforts of Restoring Arizona (a Medicaid expansion-focused interest group coalition) in counteracting the intense resistance to expanding the state’s Medicaid program. This project, therefore, shines a spotlight on Arizona as a model for advocates in the many other states still pursuing coverage expansion, as well as for implementation actors in fields outside of health care policy seeking to overcome partisan opposition to federal policy implementation. This project is also useful to a more academic audience because research into the role of interest groups during policy implementation is largely absent from the implementation literature. This thesis not only helps to fill that void, but it also recommends a number of interesting and important directions for future research around this multifaceted topic.
Photo: President Obama signing the Patient Protection and Affordable Care Act on March 23, 2010
Credit: Pete Souza/White House
“What They Learned” is a blog series exploring the thesis work of recent graduates.