State Health Policies, Federalism, and the Elderly

This article examines recent state health policy efforts for the elderly and their implications for future federal and state roles. States have been particularly active in creating programs to address the needs of the chronically ill and in seeking to modify regulatory policies and promote private sector efforts. Those efforts have involved relatively autonomous state programs as well as programs developed within the intergovernmental system. To meet the health policy needs of an increasing elderly population, future federal policies must recognize potentials for significant state contributions and seek to minimize actions that reduce policy innovation, while continuing to address the problem of limited responses in low-performance states.