In the opening pages of American Federalism in Practice, Michael Doonan highlights two gaps in the literature on policy making. First, most studies focus on the legislative process, paying less attention to what happens after a bill becomes law. Second, traditional studies of federalism provide insights into how the federal government and states interact but do little to explain why these interactions vary across the policy process. The ongoing political battles over the implementation of the Affordable Care Act (ACA) make it clear that it is not possible to fully appreciate the effects of programs and policies without understanding how federalism affects implementation. This book is an important contribution to the field, helping address these critical gaps in the literature.

This book comes at an important time in American health policy. The ACA's two major coverage expansions — Medicaid and the...

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