Chapter 1 Abstract

This book describes and analyzes health policy reforms from 2011-2021. It was funded by the Russell Sage Foundation.

How well do the America’s thousands of state legislators represent their constituents on the implementation of health policy reform at the state level? Are the decisions they make in the statehouse reflective of the wishes and needs of their constituents, or do other influences such as their own preferences, or those of their party hold more sway? We don’t now know this because of huge problems in measurement, especially at this level of government. Understanding the receptiveness of state legislators individuals and in aggregate to such varied influence will help us to predict the course of coalitions that can be constructed in each state to pass a diverse set of health reform policies.