NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH
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Victoria Perez

O'Neill School of Public and Environmental Affairs
Indiana University
1315 E 10th St
Bloomington IN 47401

E-Mail: EmailAddress: hidden: you can email any NBER-related person as first underscore last at nber dot org
Institutional Affiliation: Indiana University

NBER Working Papers and Publications

July 2019Do Local Governments Represent Voter Preferences? Evidence from Hospital Financing under the Affordable Care Act
with Justin M. Ross, Kosali I. Simon: w26094
A mainstream motivation for decentralized government is to enable public service investments to better align with political preferences that may differ by geographical region. This paper examines how political preferences determine local government provision of hospital services. We find that local governments in areas more supportive of public insurance expansion responded to such state action by increasing expenditures on hospitals, whereas those in areas that voted against such expansions used the savings to reduce property taxes. This finding suggests that local government financial responses indeed align with political preferences.
 
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