Not long after the 1966 enactment of Medicare and Medicaid, evidence emerged that unscrupulous physicians and health care organizations were gaming the system. Research over the past 50 years shows that around 10 percent of the federal government’s annual cost for these programs is attributed to fraudulent claims or abuses where hospitals and treatments have been overused for undue provider profit. This article examines early congressional attention to this problem and describes lawmakers’ attempts to find legislative solutions to it. It historicizes the dilemma of balancing the ideological limits of government regulation with cultural assumptions about professional self-regulation, focusing on a major 1972 law, the Professional Standards Review Organization (PSRO) Act. The law launched a 10-year career for PSROs, physician-staffed peer-review boards designed to identify and sanction efforts to overcharge Medicare. The article contextualizes multiple actors’ concerns over cost containment and the crisis of faith in medical authority that persisted following failures to control professional malfeasance.

This paper examines the career trajectories of new health policy elites in the American federal government, identifying areas of expertise, partisan alignments, relationships to interest groups, and institutional constraints. We demonstrate that, in both the American and French cases, policy elites who have risen through prestigious educational institutions and undertaken extensive professionalization in government, have in fact developed comparable characteristics that blend broad knowledge of social, institutional, and partisan issues with technical skills. We argue that, benefiting from extensive experience in the back offices of power, deeply entrenched in the health policy sector, and promoting a programmatic reform agenda that reaffirms the regulatory powers of government, the new American health policy elites worked behind the scenes to draft and implement the final ACA legislation. Their ambitious, far-reaching reform effort succeeded where many advocates of comprehensive reform had failed, anchoring the political and institutional framework of the U.S. health care system.

In “Disquisition on Government,” John C. Calhoun divided citizens into “tax-payers” and “tax-consumers,” foreshadowing the connection that would be made between taxation and citizenship rights in twentieth-century education policy and law. Recent scholarship has explored that relationship, analyzing the language of legal cases to demonstrate that court cases reflect citizens’ perceptions of economic stakes and related education rights. Northern foundations that focused on southern education reform during Jim Crow understood the importance of taxpayer perception to education reform and recognized that it was not a byproduct of tax policy but something that might be shaped by it. Foundations influenced education and taxation policies in North Carolina. Although they failed to address inequality and problems of the racial state, their work provides a useful framework for considering the role of both early twentieth-century foundations in education reform and, more generally, the role of foundations in civil society.

Although state constitutional conventions in the United States were once called frequently and brought about significant changes in governance, recent decades have seen little convention activity. I examine the contrast between the earlier regularity of conventions and their recent absence, but from a different perspective than is usually taken—not by explaining the recent absence but rather explaining the regularity from the 1770s through 1970s. I investigate why legislatures in prior eras agreed to call conventions and how legislators’ traditional opposition to conventions was overcome on a regular basis. After identifying the state constitutional conventions held in the US and setting aside conventions that were called to join, leave, or rejoin the Union or were instigated by institutions other than legislatures, I focus on 82 conventions called at the discretion of legislators and for reasons unrelated to joining, leaving, or rejoining the Union. I identify the issues and circumstances that were responsible for legislators’ willingness to overcome their traditional opposition to holding conventions, thereby contributing to a better understanding of both the challenges in calling conventions and the occasions when these challenges can be overcome.

This article examines the divide within the Republican Party between business interests and conservative evangelicals during the debate over the Americans with Disabilities Act of 1990 (ADA). Business interests were able to build compromises by raising their concerns over practical matters such as costs. Conservative evangelicals advocated for changes due to their moral and ideological positions on homosexuality and HIV. Conservative evangelicals did not receive their desired changes because they constructed their concerns with public safety themes. This led to conservative evangelicals and their opponents talking past each other instead of addressing their concerns. The dynamics shown from the opposition of conservative evangelicals in the ADA debate demonstrate that their influence in elections did not lead to dominance within the Republican Party in shaping policy.

In 1890, Congress passed the Second Morrill Land-Grant Act, which provided federal resources to support the creation of nineteen Black land-grant colleges. At a historical and political moment when Black Americans faced a violently repressive backlash against what progress they had achieved during Reconstruction, the successful passage and implementation of this legislation was unlikely. How did congressional lawmakers successfully pass the Morrill Land-Grant Act of 1890, and was the expansion of educational opportunity for African Americans a clearly expressed objective? Using historical analysis of primary sources, this analysis suggests that the 1890 legislation’s investment in Black colleges reflected a politically expedient compromise between northern Radical Republicans who supported greater educational access for Black citizens and Southern Democrats who wished to expand higher educational opportunity in their region while also maintaining the segregated racial order of southern educational institutions.

This article offers a comprehensive history of the development of the federal role in education and juvenile justice policy from the 1950s to the 1970s. We argue that the issues of juvenile delinquency and education became linked during this period and policies that were enacted reflected the belief that education was a solution to delinquency. In the mid-twentieth century, a broader variety of approaches to antidelinquency, such as public job creation for youth, began to fall out of favor and education became elevated as the primary policy area for addressing delinquency outside the criminal justice system. Policy makers frequently justified federal involvement in education by arguing that schools were central to antidelinquency efforts. Drawing educational institutions into the fight against delinquency made schools susceptible to the punitive turn in crime policy. Ultimately, these developments have introduced punitive policies into schools and pushed antidelinquency efforts away from broader structural reforms.

This article examines Rockefeller Republicanism and its status within the Republican Party by looking at the evolution of Nelson Rockefeller’s support for social welfare policy between 1958 and 1975. New York Governor Nelson Rockefeller regularly appears in histories of modern conservatism as the embodiment of the liberalism that conservatives rejected, but these works rarely account for the entirety of Rockefeller’s career. Rather than focus on Rockefeller’s challenges to the national Republican Party in 1960 and 1964, which results in an incomplete representation of Rockefeller Republicanism, this article reassesses moderate Republicanism’s perceived dominance and Rockefeller’s advocacy for liberal domestic policies and commitment to racial liberalism in New York. A full account of Rockefeller’s struggles to find common ground with conservative New York Republicans and adoption of conservative positions related to law enforcement and welfare reform thwarted one of the GOP’s best opportunities to assemble a multiracial and cross-class constituency.

Equating the U.S. government with the national government, historians of the AIDS epidemic have hitherto ignored the role of the states in shaping the early policy response to the disease. Responding to this historiographical lacuna, this article argues that California acted as a policy innovator during the initial years of the epidemic, intervening more effectively than the federal government in the areas of AIDS health care, antibody testing, and prevention education. California’s policy leadership drew significant impetus from a group of gay policy makers, who entered state employment in the early 1980s and relied extensively on clandestine and illicit strategies, particularly a network of “closeted” bureaucrats. Charting the career arcs of these gay policy makers shines a spotlight on the organizational growth of state LGBTQ groups in the 1980s and the evolving role of the “closet” in the modern gay rights movement.

This article examines out-of-home placements in Denmark over a seven-decade period from 1905 to 1975. The Danish state delegated this responsibility to a, using the words of Kimberly J. Morgan and Ann Shola Orloff, “difficult-to-classify public-private hybrid,” the Children’s Welfare Boards (CWBs). These CWBs comprised private citizens selected by the municipality. The article shows how the CWBs acted as interpreters, mediators, and implementers of state policy at the street level while also functioning as the direct link between government and citizens. The findings reveal an inherent conflict between center and periphery in that the state’s nationwide regulations and bureaucratic practices, intended to apply to all citizens uniformly, were to be implemented by local units within municipalities that operated according to logics other than those of the state. The vase of variations in child out-placement practices shows the importance of examining local variations in studying the history of policy implementation.

Toleration of suicide and the campaign to legalize euthanasia, this article shows, are historically separate developments. From the early 1880s to the 1900s the American press featured moral discussions of suicide alongside gloomy roll calls and expressions of anxiety about an alleged increase in suicide. Focusing on an extensive discussion in the San Francisco Call in 1896, the article shows that Robert G. Ingersoll’s liberal individualist toleration of suicide clearly resonated with many Americans at the time. I trace the rise of suicide from private tragedy to public issue in the United States. Perhaps surprisingly, there was no crossover with euthanasia and no call whatever for assistance with suicide, despite the frequent employment of the plight of the terminally ill in the discussion. Finally, the article shows that those who called for euthanasia thought of it as a human utility and not a right.

The analysis examines the effort to incorporate labor rights into the American conception of civil liberties and the opposition to that endeavor. It focuses on three Senators—Robert Wagner, Robert La Follette, Jr., and Elbert Thomas—and New Deal officials who conceived of the National Labor Relations Act as a cornerstone of the effort to achieve “economic justice” and defended the law against its critics. It examines the opponents, including the National Association of Manufacturers and an anticommunist alliance between southern Democrats and Republicans. An ideological counteroffensive recast the supporters of social rights as un-American opponents of free enterprise and defined civil liberties as protecting the individual from an expansionist state and labor bosses. The analysis demonstrates the multiple causes for the disappearance of ideological space for conceiving that protection from oppressive employers constituted a civil liberty and the displacement of labor rights by the “right to work.”

As early as 1704, noncitizen immigrants were legally allowed to vote in what would become the United States. By the end of the eighteenth century, noncitizens could legally vote in most states. State lawmakers offered the franchise as an incentive for white, male, Europeans of working age to migrate. However, rising immigration and nativism led states to reconsider alien suffrage, as noncitizen voting was known, and alien suffrage nearly disappeared by the 1840s. Revived by territorial expansion, demands for cheap labor, urbanization, racism, and sexism, alien suffrage expanded in the mid-to-late nineteenth century, peaking a century after the nation’s founding. However, resurgent nativism, wartime xenophobia, and corruption concerns pushed lawmakers to curtail noncitizen voting, and citizenship became a voting prerequisite in every state by 1926.

The American aircraft industry’s important role in the economic, military, and cultural expansion of the United States over the past one hundred years has been well documented by historians. But America’s twentieth century aerial dominance was not preordained. After World War I, the nascent American aircraft industry faced a concerted British effort to dump thousands of war surplus machines on the U.S. market. With aircraft outside of the nation’s tariff regime, members of the Manufacturers Aircraft Association turned to Congress for emergency protections in the face of what they considered an existential threat. Despite efforts to equate a strong industrial base for aviation with the national defense, aircraft antidumping legislation became mired in partisan debates over tariff policy and accusations of wartime corruption. In the absence of relief from Congress, the Wright patent served as a barrier against the importation of foreign surplus machines.

This article presents case studies of pardons in the presidencies of Washington, Adams, and Jefferson. In doing so, the article moves away from the idea in existing scholarship that pardons of the past were largely noble acts of statecraft, untouched by ideological, partisan, or personal political motivations. Instead, it develops an account of how and why these pardons should be understood as both enabling presidents to achieve certain political objectives and, simultaneously, operating in an inherited environment in which presidents used existing resources to legitimate their pardons. In so doing, presidents refashioned those inherited resources and, thereby, created new resources for future presidents. The picture that emerges is of pardons as both sources of political innovation and political constraint.

Nineteenth-century seamen were subject to exploitation by boardinghouse keepers who recouped seamen’s debt by pocketing their advance wages from a future voyage. New York’s 1866 Act for the Better Protection of Seamen, the U.S. Shipping Commissioners Act of 1872, and the 1884 Dingley Act all purported to respond to this practice of “crimping,” but each of these acts simply allowed for new arrangements that continued to exact money from seamen. Even when corruption or collusion operated and were publicly known, such practices were tolerated because they continued to provide a steady supply of maritime labor, which promoted maritime commerce. This article considers the misleading political development of this legislation in the context of the early years of spoils reform.

This paper traces the political development of Congressional gun control issue framing (with a specific focus from the early 1990s to the present), demonstrating that there have been two primary contexts in which gun control policy has been debated over this time frame: as a component of general crime control and as a specific response to mass shooting events. It identifies the primary historical, political, and electoral forces shaping the gun control debate in a given period while distinguishing the critical changes that drove the evolution from a crime control to a mass shooting focus. It assesses the degree of policy coherence and electoral salience specific to each context, illuminating why “gun control as crime control” had bipartisan Congressional support in the early 1990s and identifying what comparative disadvantages hinder the mass shooting focus of the present while also recognizing that the latter unfolded against a backdrop of heighted partisan polarization. The paper concludes that although one cannot compare the crime control and mass shooting framing contexts in a political vacuum, the electoral implications particular to each are relevant for understanding legislative action or inaction in Congress over the past thirty years, if more so in some periods than others.

This article explores the role of business in supporting and benefiting from nature protection during the second half of the nineteenth century. It begins with the support of business for protecting scenic wilderness in California and the creation of Yellowstone, as well as the role of the railroads in encouraging easterners to visit to the nation’s western national parks—all designed to create economic value by promoting tourism. It then examines the efforts of a wide range of business interests to protect the White Mountains of New Hampshire and the Adirondack forest in New York State. The later effort was led by business interests from New York City who worried that deforestation would impair freight traffic on the Erie Canal and Hudson River as well as endanger the city’s water supplies. This article compliments Hay’s research on business and conservation during the Progressive Era by demonstrating that business also played a critical role in supporting wilderness and forest protection.

The Kerner Commission’s report is regarded as one of the nation’s most important works on race. However, the earlier rejection of an internal staff paper (“The Harvest of American Racism”) because it was “too radical” left a “gaping hole” in the Commission’s plans (“Harvest,” which sought to use social science to explain why only some cities encountered rioting, was to have been the report’s “core chapter”) and caused a staff split that threatened its work. Much has been written about the challenges of incorporating social science and public policy with references about them being in separate worlds with different languages, schedules, values, etc. This article examines to what extent any of these challenges was present as “Harvest” was being written and reviewed. It then seeks to determine what influence any complicating factor may have had and what, if anything, could have been done to produce a different outcome.

This article examines the financial industry’s critical role in retargeting U.S. health policy goals of improving peoples’ health in the 1960s to those of expanding institutional wealth in the 1970s. Government collaborated with finance to support not-for-profit hospitals’ use of debt to build services that augmented capital and operated like for-profit businesses. Certificate of Need, hospital rate review, and national health planning programs came to assess hospital performance in terms of capital formation, returns on investment, and bond ratings. The regulatory programs helped gentrify medicine by reinforcing selective investment in lucrative, high-tech services that market specialty procedures to affluent populations in place of disease control, primary care, and general acute care for all. Their actions laid the groundwork for the 1980s finance industry coup, which employed market ideology to dominate health policy at the expense of equality, effectiveness, and public health governance.