State Innovation Waivers: The Efficacy of Federalist Approaches to the Affordable Care Act

In this essay, I discuss the costs and benefits to state-led changes to the Patient Protection and Affordable Care Act (ACA). I begin by offering background surrounding the creation of the ACA and the goals President Obama and Democratic lawmakers hoped it would accomplish. Then, I discuss Medicaid waivers as a primer due to the relative recentness of the ACA waivers. Following that discussion, I examine three case studies of states that have attempted to or have successfully made changes to the ACA. Based on the case studies and the frequent conservative tilt of Medicaid waivers, I find that federalist approaches to the ACA are more likely to undermine the ACA than they are to strengthen it. Although waivers were included in federal legislation as a non-partisan vehicle to allow states to be laboratories for innovation, the large role the President plays in approving or denying waivers and creating the regulations surrounding waivers puts state innovation at the mercy of whoever occupies the Oval Office

Global consensus Monte Carlo

To conduct Bayesian inference with large data sets, it is often convenient or necessary to distribute the data across multiple machines. We consider a likelihood function expressed as a product of terms, each associated with a subset of the data. Inspired by global variable consensus optimisation, we introduce an instrumental hierarchical model associating auxiliary statistical parameters with each term, which are conditionally independent given the top-level parameters. One of these top-level parameters controls the unconditional strength of association between the auxiliary parameters. This model leads to a distributed MCMC algorithm on an extended state space yielding approximations of posterior expectations. A trade-off between computational tractability and fidelity to the original model can be controlled by changing the association strength in the instrumental model. We further propose the use of a SMC sampler with a sequence of association strengths, allowing both the automatic determination of appropriate strengths and for a bias correction technique to be applied. In contrast to similar distributed Monte Carlo algorithms, this approach requires few distributional assumptions. The performance of the algorithms is illustrated with a number of simulated examples

The Consequences of Presidential Patronage for Federal Agency Performance

In this article, we examine the relationship between presidential patronage and federal agency performance, Using Program Assessment Rating Tool (PART) management scores for 1,016 federal programs during the Bush Administration, we compare the performance of federal programs administered by appointees from the campaign or party against programs run by other appointees or career professionals. We introduce new means of overcoming the shortcomings of PART scores in order to make reliable inferences from this measure of federal program performance. We find that federal programs administered by appointees from the campaign or party earn lower PART scores than programs run by other appointees or by career executives. We conclude that although appointing persons from the campaign or party provides presidents an important source of political capital and arguably improves accountability, it also has costs for agency performance

Lifetime performance characteristics of screen-printed potentiometric Ag/AgCl chloride sensors

Ag/AgCl chloride sensors were fabricated using thick-film technology. A number of different formulations were prepared and chloride responses were investigated over time. Near Nernstian, identical responses were observed over the first 160 days with an average chloride sensitivity of -51.8 ± 0.4 mV per decade change in chloride concentration (pCl), irrespective of paste formulation. After 6- months continuous immersion in tap water, pastes formulated with a glass binder began to exhibit a loss in sensitivity whilst those formulated from a commercial thickfilm dielectric paste remained functional for the best part of a year. The difference is attributed to the inclusion of proprietary additives in the commercial paste aiding adhesion and minimising AgCl leaching