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Unequal CoverageThe Experience of Health Care Reform in the United States$
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Jessica M. Mulligan and Heide Castañeda

Print publication date: 2017

Print ISBN-13: 9781479897001

Published to NYU Press Scholarship Online: September 2018

DOI: 10.18574/nyu/9781479897001.001.0001

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PRINTED FROM NYU Press SCHOLARSHIP ONLINE (www.nyu.universitypressscholarship.com). (c) Copyright University of NYU Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in NYSO for personal use.date: 25 June 2022

Outsourcing Responsibility

Outsourcing Responsibility

State Stewardship of Behavioral Health Care Services

(p.231) 9 Outsourcing Responsibility
Unequal Coverage

Cathleen E. Willging

Elise M. Trott

NYU Press

Cathleen E. Willging and Elise M. Trott argue that politically driven processes of the past have shaped the current context of mental health care delivery in New Mexico. Provisions of the ACA, including the expansion of Medicaid and outreach to underserved populations, offered the possibility of improving access and services for New Mexicans struggling with unmet treatment needs. However, as the authors argue, public stewards manipulated key ACA provisions to propagate unsubstantiated allegations of waste, fraud, and corruption against safety-net service providers. This chapter shows how public-private partnerships in the Medicaid arena, discourses of transparency, and technologies of accountability can engender truthiness claims, obscure vital information, destabilize a behavioral health care safety net, and deny low-income citizens care. They argue that scholars have the responsibility to attend to the “total bureaucratization” of government-funded health care systems that also allows such abuse of authority.

Keywords:   public stewards, behavioral health, New Mexico, total bureaucratization, transparency, truthiness, fraud, corruption, safety net, ACA, public-private partnerships

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