Federalism Complicates the Response to the COVID-19 Health and Economic Crisis: What Can Be Done?

19 Pages Posted: 26 Sep 2020

See all articles by Nicole Huberfeld

Nicole Huberfeld

Boston University - School of Public Health; Boston University School of Law

Sarah Gordon

Boston University

David K. Jones

Boston University

Date Written: May 28, 2020

Abstract

Federalism has complicated the US response to the novel coronavirus. States’ actions to address the pandemic have varied widely, and federal and state officials have provided conflicting messages. This fragmented approach has cost time and lives. Federalism will shape the long-term health and economic impacts of COVID-19, including plans for the future, for at least two reasons: First, federalism exacerbates inequities, as some states have a history of underinvesting in social programs, especially in certain communities. Second, many of the states with the deepest needs are poorly equipped to respond to emergencies due to low taxes and distrust of government, leading to inadequate infrastructure. These dynamics are not new, but they have been laid bare by this crisis. What can policy makers do to address the inequities in health and economic outcomes that federalism intensifies? The first section of this article offers a case study of the Mississippi Delta to illustrate the role of federalism in perpetuating the connection between place, health, and economics. The second section examines challenges that safety net programs will face when moving beyond the acute phase of COVID-19. The final section explores near-, middle-, and long-term policy options to mitigate federalism’s harmful side effects.

Keywords: Affordable Care Act, federalism, Medicaid, health reform, coronavirus, COVID-19, state health policy

Suggested Citation

Huberfeld, Nicole and Gordon, Sarah and Jones, David K., Federalism Complicates the Response to the COVID-19 Health and Economic Crisis: What Can Be Done? (May 28, 2020). Journal of Health Politics, Policy and Law, Forthcoming, Boston Univ. School of Law, Public Law Research Paper No. 20-39, Available at SSRN: https://ssrn.com/abstract=3698878 or http://dx.doi.org/10.2139/ssrn.3698878

Nicole Huberfeld (Contact Author)

Boston University - School of Public Health ( email )

715 Albany Street
Boston, MA 02118
United States

Boston University School of Law ( email )

765 Commonwealth Avenue
Boston, MA 02215
United States

Sarah Gordon

Boston University ( email )

595 Commonwealth Avenue
Boston, MA 02215
United States

David K. Jones

Boston University ( email )

595 Commonwealth Avenue
Boston, MA 02215
United States

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