Federalism Implications for Medicaid in California Essay

September 21, 2021 by Essay Writer

The concept of federalism presupposes the existence of two different layers of authority governing the same people and the same territory. The metaphor ‘marble cake’ is employed to explain such a relationship when there is a close collaboration between the two governments. The metaphor ‘layer-cake,’ in its turn, denotes the presence of misunderstandings between the two types of ruling authorities. An example used to compare and contrast the two metaphors is the system of Medicaid as controlled by the federal government and by the state government.

The government of the USA has introduced a program covering the health needs of underserved and vulnerable populations, Medicaid. The State of California has its own Medicaid office that is called Medi-Cal. Although both entities differ in titles and locations of the main offices, they perform the same function, which is controlling the eligibility of California citizens to the program. What is more important, Medicaid and Medi-Cal offer healthcare services for the citizens qualified as viable participants of the program.

The eligibility criteria are the same at the governmental and state levels. Both Medicaid and Medi-Cal provide healthcare services for citizens with low income and people with specific diseases such as HIV, tuberculosis, and breast cancer (“Eligibility,” n.d.; “Medi-Cal,” n.d.). It is necessary to note that Medi-Cal receives equal financing from the state and federal government.

Taking into consideration the mutual purposes and financing of the program by both governments, it is viable to conclude that the ‘marble cake’ metaphor is more suitable to describe this program area than ‘layer-cake.’ There are collaboration and coordination of both entities’ responsibilities, and there are no conflicts or tensions. I do not have a different metaphor to explain federalism. ‘Marble cake’ seems the most suitable interpretation of the situation.


Eligibility. (n.d.). Web.

Medi-Cal. (n.d.). Web.

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