Do the 50 American States Give Voters What They Want on Health and Immigration?
The 50 American state governments have been faced with many questions related to healthcare and immigration in the past two decades. Repeatedly under the Bush, Obama, and Trump administrations, the U.S. Congress has weighed a wide array of alternatives in terms of how to reform immigration policy in the context of a growing population of undocumented immigrants. In each case, Congress failed to act, leaving a vacuum of policy decisions to the states. Further, the states faced choices on how to respond to the Patient Protection and Affordable Care Act of 2010, such as whether to form their own insurance marketplaces and whether to opt out of the Medicaid expansion. So whether on account of federal action or inaction, the states have had to face many policy choices on the salient issues of health and immigration lately. When the state governments face these choices, do they give their voters what they want? Our recent article in the Journal of Public Policy (JPP) shows that state governments do not have a perfect track record, but have made some improvement on these issues.
Lax and Phillips (2012) show that there is a paradox when considering representation at the state level: On the one hand state policy is responsive to what constituents want. In other words, when a state’s electorate is more favorable towards a certain policy, then the probability that the state government will adopt such a policy rises. However, state policy is often not congruent with what constituents want. This means that the policy a state adopts is often not in-line with what a majority of the electorate would prefer.
How does such a paradox emerge? The figure below illustrates this pattern with some data from our study. This figure shows our data for public opinion and public policy in 2014 on the issue of whether undocumented immigrants should be granted drivers’ licenses. The horizontal axis shows the percentage of a state’s citizens that favor granting licenses, and the 50 states are sorted on the vertical axis from the least to the most favorable on this issue. Each state is represented by one of two characters: a black open circle if they do not grant licenses to undocumented immigrants (the conservative policy), and a red solid triangle if they do grant licenses (the liberal policy).
The figure shows clear responsiveness among the states on this issue: The larger the percentage of the public to favor granting drivers’ licenses, the higher the probability the state will adopt a policy of granting licenses. We can see this in that 9 of the 15 states where this policy has the greatest support have this policy in place. Meanwhile Utah is the only state outside of the top fifteen that has the policy. The fact that the probability increases with increases in public support indicates democratic responsiveness to the will of the voters. However, notice that not one state has majority support for this policy: California had the highest support in 2014 with around 40% support for granting licenses, but not one state had 50% support. Therefore, we would say that all 10 states that grant drivers’ licenses to undocumented immigrants have a policy that is incongruent with the wishes of the majority. In all fifty states, a majority would rather the policy not be in place.
For this one issue in the year 2014, we see that 40 of the 50 states actually had a drivers’ license policy that was congruent with the majority will. However, examining a broad basket of issues, that level of congruence is not common. In our study, we reexamined seven policy questions related to health and immigration that were originally a part of Lax and Phillips’s (2012) study. On immigration we studied four issues: whether a state allows bilingual education to teach some students in their native language, whether undocumented immigrants can be granted drivers’ licenses, whether children of undocumented immigrants can receive in-state tuition for college, and whether public or private employers are required to use the E-Verify program to confirm legal immigration status. On health we observed three issues: whether the state allows SCHIP funding for children in a family of four making $60,000 a year, whether the state allows adults to use marijuana for medical purposes with a prescription, and whether doctor-assisted suicide should be allowed.
Lax and Phillips found in the year 2008 that, across these seven issues, policy corresponded to the majority will 42% of the time. By the time of our study of policy in 2014, we found 52% congruence across these seven issues. This represents a discernible and encouraging improvement, even if not a transformative one. Where did this improvement emerge? We find that the states that moved from a policy that was incongruent with the majority’s will to policy that was congruent were more likely to change if there was a big majority opposing policy as it was. As an example, our findings would imply that of the 10 states in the displayed figure which grant drivers’ licenses to immigrants, we would expect that Utah would be the most likely to remove this policy because it is the state with the largest opposition to the policy in place (with over 80% opposition). On issues as important and well covered as immigration and health, then, state policy is gradually moving to be more in line with respective public preferences. It is in states with a clearly lopsided majority where change is most likely to emerge.
– Christopher Hare, University of California at Davis, and James E. Monogan III, University of Georgia.
– The authors’ new JPP article is now online and available free of charge until the end of January 2018.