Beland Rocco Waddan 8Béland, Daniel, Philip Rocco, and Alex Waddan. 2016.  Obamacare Wars: Federalism, State Politics, and the Affordable Care Act. Lawrence, KS: University Press of Kansas.

This book is the first monograph devoted to the politics of the Affordable Care Act’s implementation in the 50 states. Our political and comparative analysis of federalism and health care reform focuses on three major policy innovations : health-insurance exchanges, Medicaid expansion, and regulatory reform.


Praise for Obamacare Wars:

“Highly recommended” – Choice

Obamacare Wars might be the guide to policy in a new world of polarized, racialized politics where at least one of our two political parties seems not to have read classical political science about coalitions and interests.”  – Perspectives on Politics 

Obamacare Wars provides a thoughtful, well-written account of the fascinating politics associated with [the ACA’s] implementation. The book illustrates the value of a detailed empirical case study. It is an important contribution to the field of policy implementation and the politics of health policy.” – Political Science Quarterly

“Béland, Rocco, and Waddan contribute significantly to our understanding of implementation in federal systems by demonstrating convincingly that the politics and strategies of implementing this single piece of health care reform legislation in the American states were myriad and a function not only of partisan polarization but also of the diverse policy issues embedded within the law.”- The Journal of Politics

Obamacare Wars Federalism: State Politics and the Affordable Care Act provides insight into policy and program implementation of a complex and politically contentious law. (…) The strength of the work is that it takes previous theory on implementation, adds to it and applies it to the implementation of the ACA. The results help explain how and why health care reform has been unevenly enacted across the states.” – Publius: The Journal of Federalism

“The first serious analysis of a neglected but vital aspect of the Affordable Care Act, Obamacare Wars offers an informed and revealing look at the varied role of the states in the implementation of President Obama’s landmark federal health law. Ideal for both graduate and undergraduate courses, as well as law, business, and public health programs, the book should be read by anyone trying to understand the post-enactment struggles that have resulted in millions of Americans obtaining new coverage—and millions more waiting for it as their state leaders resist federal intentions.” – Jacob S. Hacker, Yale University

Edited Volume

  • Callen, Zachary and Philip Rocco, eds. American Political Development and the Trump Presidency (Philadelphia, PA: University of Pennsylvania Press, 2020).

Journal Articles 


2021                Rocco, Philip, Jessica Rich, Kasia Klasa, Ken Dubin, and Daniel Béland. “Who Counts Where?Federalism and the Politics of COVID-19 Surveillance.” Journal of Health Politics, Policy, and Law 46 (4). 

2021                Rocco, Philip. “Keeping Score: The Congressional Budget Office and the Politics of Institutional Durability.” Polity 53 (4).

2021                Lopez-Santana, Mariely and Philip Rocco. “Fiscal Federalism and Economic Crises in the United States: Lessons from the COVID-19 Pandemic and Great Recession.” Publius 51 (3).

2021                Lecours, André, Daniel Béland, Alan Fenna, Tracy Beck Fenwick, Mireille Paquet, Philip Rocco, and Alex Waddan. “Federalism and the Covid-19 crisis: Canada, Australia and the United States in Comparative Perspective.” Publius 51 (3).

2021                Béland, Daniel, Greg Marchildon, Anahely Medrano, and Philip Rocco, “COVID-19, Federalism, Policy Feedback, and Health Care Funding in Canada, the United States, and Mexico.” Journal of Comparative Policy Analysis.

2020                Béland, Daniel, Shannon Dinan, Philip Rocco, and Alex Waddan. “Social Policy Responses to COVID-19 in Canada and the United States.” Social Policy and Administration.

2020                Rocco, Philip. “Direct Democracy and the Fate of Medicaid Expansion.” JAMA Health Forum. August 21.

2020                Rocco, Philip, Daniel Béland, and Alex Waddan. “Stuck in Neutral? American Federalism and the Politics of Counter-Cyclical Responses to COVID-19.” Policy & Society 39 (3): 458–77. +

2020                Rocco, Philip and Andrew S. Kelly. “An Engine of Change? The Affordable Care Act and the Shifting Politics of Medicare Demonstration Projects.” RSF: The  Russell Sage Foundation Journal of the Social Sciences 6(2): 67–84. +

2020                Rocco, Philip, Ann Keller, and Andrew S. Kelly. “State Politics and the Uneven Fate of Medicaid Expansion.” Health Affairs 39 (3): 494–501. +

2020                Béland, Daniel Philip Rocco, and Alex Waddan. “The Affordable Care Act in the States: Fragmented Politics, Unstable Policy.” Journal of Health Politics, Policy,  and Law 45(4): 647–660.

2020                Béland, Daniel, Michael Howlett, Philip Rocco, and Alex Waddan, “Designing Policy Resilience: Lessons from the Affordable Care Act,” Policy Sciences 53(2): 269–89.   

2019                Kelly, Andrew S. and Philip Rocco. “From Trial and Error to Major Reform: The Politics of Medicare Demonstration Projects.” Public Administration 97 (3): 621–38.

2019                Béland, Daniel, Philip Rocco, and Alex Waddan. “The ACA and the Politics of Policy Feedback.” Policy Studies Journal 47 (2): 395–422.     

2018                Rocco, Philip, Andrew S. Kelly, and Ann Keller. “Politics at the Cutting Edge:  Intergovernmental Policy Innovation in the Affordable Care Act.” Publius: The Journal of Federalism 48 (3): 425–453. 

2018                Béland, Daniel, Philip Rocco, and Alex Waddan. “Obamacare in the Trump Era: Where Are We Now? Where Are We Going?” The Political Quarterly 89 (4): 687–694.

2018                Béland, Daniel, Anahely Medrano, and Philip Rocco. “Federalism and the Politics of Bottom-Up Social Policy Diffusion in the United States, Mexico, and Canada.” Political Science Quarterly 133 (Fall): 527–560.

2018                Rocco, Philip and Simon Haeder. “How Intense Policy Demanders Shape Post- Reform Politics: Evidence from the Affordable Care Act,” Journal of Health  Politics, Policy, and Law 43 (2): 271–304.  

2018                Shi, Shih-Jiun, Daniel Béland, Philip Rocco, and Alex Waddan, “Paths to (De)centralization: Territorial Dynamics and Social Policy in the People’s Republic of China and the US.” Environment and Planning C 36 (5): 897–915.

2017                Rocco, Philip. “The Anti-Analytic Presidency Revisited.” The Forum 15(2): 363–378. 

2017                Rocco, Philip. “Informal Caregiving and the Politics of Policy Drift in the United States.” Journal of Aging and Social Policy 29 (5): 413-432.  

2017                Jarlenski, Marian, Philip Rocco, Renu Tipirneni, Amy Kennedy, Nivedita Gunturi, and Julie Donohue. “Making Health Policy for Low-Income Populations: An Assessment of Public Participation in a New Medicaid Waiver Process.” Journal of Health Policy, Politics, and Law 42 (6): 1039-1064.  

2017                Rocco, Philip, Andrew S. Kelly, Daniel Béland, and Michael Kinane.“The New Politics of US Health Care Prices: Institutional Reconfiguration and the Emergence of All-Payer Claims Databases.” Journal of Health Politics, Policy, and Law 42 (1): 5–52. +

2017                Rodakowski, Juleen, Philip Rocco, Maqui Ortiz, Barbara Folb, Sally C. Morton, Richard Schulz, Lu Hu, Sally Caine Leathers, and A. Everette James. “Integrating Caregivers of Older Adult Patients into Discharge Planning to Lower Resource Utilization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Journal of the American Geriatrics Society 65 (8): 1748–1755.  

2016                Béland, Daniel, Philip Rocco, and Alex Waddan, “Obamacare and the Politics of Universal Health Insurance Coverage in the United States.” Social Policy & Administration 50(4): 428–451.

2016                Béland, Daniel, Philip Rocco, and Alex Waddan, “Reassessing Policy Drift:

Social Policy Change in the United States,” Social Policy & Administration 50 (2): 201–218.

2015                Rocco, Philip, Walid F. Gellad, and Julie M. Donohue. “Modernizing Medicaid Managed Care: Can States Meet the Data Challenges?” JAMA 314 (15):1559–60. 

2015                Tummers, Lars and Philip Rocco. “Serving Clients When the Server Crashes: How Frontline Workers Cope with E-Government Challenges.” Public  Administration Review 75(6): 817–827.

2015                Béland, Daniel, Philip Rocco, and Alex Waddan, “Polarized Stakeholders and Institutional Vulnerabilities: The Enduring Politics of the Affordable Care Act.” Clinical Therapeutics 37 (4): 720–726.

2015                Rocco, Philip. “Making Federalism Work? The Politics of Intergovernmental Collaboration and The PPACA.” Journal of Health and Human Services Administration 37(4): 412–461.

2014                Béland, Daniel, Philip Rocco, and Alex Waddan. “Implementing Health Reform in the United States: Intergovernmental Politics and the Dilemmas of Institutional Design.” Health Policy 116 (Spring): 51–60.

2014                Béland, Daniel, Philip Rocco, and Alex Waddan. “Obamacare, Universal Credit, and the Trilemma of Public Services.” Public Administration Review 74(2):142–3.

2014                Rocco, Philip and Chloe Thurston. “From Metaphors to Measures: Observable Indicators of Gradual Institutional Change.” Journal of Public Policy 34 (1): 35–62.

2014                Chatfield, Sara and Philip Rocco. “Is Federalism a Political Safety Valve? Evidence from Congressional Decision-Making, 1960–2005.” Publius: The Journal of Federalism 44 (1): 1–23.

Book Chapters

Forthcoming   Rocco, Philip. “Laboratories of What? American Federalism and the Politics of Democratic Subversion.” In Democratic Resilience: Can the US Withstand Rising  Polarization?, edited by Robert Lieberman, Suzanne Mettler, and Ken Roberts. New York: Cambridge University Press.  

2020               Rocco, Philip. “Medicaid Expansion: Intergovernmental Reform meets Nationalized Politics.” In Medicare and Medicaid: A Reference Handbook, edited by Greg Shaw, 126–135. ABC-CLIO.  

2020                Rocco, Philip. “The Quiet Politics of Medicaid Work Requirements.” In Medicaid: Enrollment, Eligibility, and Key Issues, edited by Daniel Lanford, 111–40. Hauppage, NY: Nova Science Publishers.

2020                Rocco, Philip and Zachary Callen. “Introduction.” In American Political Development and the Trump Presidency, edited by Zachary Callen and Philip Rocco, 1–12. Philadelphia, PA: University of Pennsylvania Press. 

2020                Rocco, Philip. “The Policy State and the Post-Truth Presidency.” In American Political Development and the Trump Presidency, edited by Zachary Callen and Philip Rocco, 114–29. Philadelphia, PA: University of Pennsylvania Press.

2011                Rocco, Philip. “Wissensproduktion in der RAND Corporation.” In Macht und Geist im Kalten Krieg, edited by Bernd Greiner, Tim B. Müller, Claudia Weber, 301–20. Hamburg: Hamburger Institut für Sozialforschung.*


2021                Kass, Amanda, Philip Rocco, and Isabella Romano. Strengthening Local Government Finances: State and Federal Policies for a Crisis Era. University of Illinois at Chicago, Government Finance Research Center.

2020                Reinecke, David and Philip Rocco. The Human Costs of Local Fiscal Crises During COVID-19.  Report prepared under contract with the National League of Cities.

2016                Everette James, Meredith Hughes, and Philip Rocco, Addressing the Needs of Caregivers at Risk: A New Policy Strategy. University of Pittsburgh, Health Policy Institute

2015                Everette James, Sally Morton, William Dunn, Philip Rocco, et al., Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions. University of Pittsburgh, Health Policy Institute

Reviews and Essays 

2020                            Ending Federalism as We Know It. Jacobin 39: 58-64.

2020                            Review of Matt Grossmann, Red State Blues. Perspectives on Politics 18(2): 627–29.

2019                            Review of Didi Kuo, Clientelism, Capitalism, and Democracy: The Rise of Programmatic Politics in the United States and Britain. Public Administration 97(4): 960–61.

2018                            Review of Norma Riccucci, Policy Drift: Shared Powers and the Making of U.S. Law and Policy. American Review of Public Administration.

2018                            Review of Jamila Michener, Fragmented Democracy: Medicaid, Federalism, and Unequal Politics. Perspectives on Politics 16 (December): 1166–1168.  

2018                            Review of Karen Orren and Stephen Skowronek, The Policy State: An American Predicament. Journal of Interdisciplinary History 49 (2): 346–347.  

2018                            Review of Kristin Szylvian, The Mutual Housing Experiment: New Deal Communities for the Urban Middle Class. Political Science Quarterly 132 (4): 777-778.

2017                            Review of Pamela Clouser McCann, The Federal Design Dilemma. Publius: The Journal of Federalism 47(4), e13.

2016                            Open Government and the Politics of Public Knowledge in the United States. Public Administration 94 (3): 846–853.

2015                            Review Essay: Mapping the Policy State. Public Administration 93(1): 248–254.

2014                            Review Essay: Muddling Through Hard Times. Public Administration 92 (2): 525–530.

2013                            Review of Kimberley Morgan and Andrea Campbell, The Delegated Welfare State: Medicare, Markets and the Governance of Social Policy, Public Administration 91 (4): 1075–77.  

2013                            Review of Joanna Grisinger, The Unwieldy American State. Public Administration Review 73 (5): 765–7.