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The Search for Counter-Partisan Reform: Ideology & Influence in Medicaid & Marijuana Policy Reform
Dissertation

The Search for Counter-Partisan Reform: Ideology & Influence in Medicaid & Marijuana Policy Reform

Joseph Peter Bolton
Doctor of Philosophy (PhD), Washington State University
2026
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Abstract

Counter-Partisan Policy Reform Ideology Interest Groups Partisanship Polarization Policy Diffusion
The current climate of partisan politics and ideological polarization often presents an impediment to policy reform. Amidst high polarization within most state legislatures, and with half of the states even more polarized than Congress, our politics have produced longstanding policy stasis. However, a fascinating puzzle remains: why do some states adopt counter‑partisan reforms while others remain static? This project examines the causes of counter-partisan policy reform — when partisan-controlled legislatures pass a reform that the majority party either explicitly opposes or does not support in its official platform — in two intriguing areas: Affordable Care Act Medicaid expansion (2010-2023) and marijuana policy reform (1996-2023). Four key factors are examined: partisan polarization; close partisan division/competitiveness; border state and co-partisan policy diffusion; and interest group pressure via lobbying. Bridging polarization and policy diffusion literatures, this work explores how these (at times) countervailing forces interact to shape state reform decisions for two contentious issues. This research finds that even in a deeply polarized and competitive era, policy diffusion can generate counter-partisan reform, though slowly. Although it is often conceptualized as driving 1:1 emulation, for counter-partisan reform issues, diffusion appears to exert greater pressure toward intermediate reforms (e.g., partial or conditional Medicaid expansion and marijuana decriminalization). This research also shows that institutions matter: bicameralism and ballot initiatives shape whether counter-partisan reform occurs. Ultimately, this project finds that even in highly polarized contexts, alternative policy venues, interest group lobbying, and diffusion pressures can still produce meaningful change. Taken together, this study demonstrates how counter‑partisan reform emerges within the context of high ideological polarization — a matter of great importance in this present moment.

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