Monday, December 7, 2020
The OECD recently issued a report on Taxation and Philanthropy that will likely be of interest to our readers.
The summary provides: "This report provides a detailed review of the tax treatment of philanthropic entities and philanthropic giving in 40 OECD member and participating countries. The report first examines the various arguments for and against the provision of preferential tax treatment for philanthropy. It then reviews the tax treatment of philanthropic entities and giving in the 40 participating countries, in both a domestic and cross-border context. Drawing on this analysis, the report then highlights a range of potential tax policy options for countries to consider."
Saturday, September 19, 2020
The "deaccessioning police" argue that it is "unethical" for art museums to "deaccession" or "sell" works of art from their collections for any purpose other than buying different works of art, because museums do not really own the art in their collections, but only hold it subject to the "public trust doctrine." This essay observes that the public trust doctrine doesn't apply to art, and that the arguments made by the deaccessioning police are absurd, on their own terms.
Jacob Hale Russell (Rutgers) has posted For Whom Are Non-Profit Managers Trustees? The Contractual Revolution in Charity Governance, which will be published in Fiduciary Obligations in Business (forthcoming). Here is the abstract:
This chapter chronicles an unnoticed aspect of the intellectual history of the “contractarian” paradigm, the descriptive claim that firms are best characterized as nexus of contracts. Although the paradigm’s rise in the 1980s in the corporate world is well known, little has been said about its success in rewriting both theory and doctrine in charitable and not-for-profit law. The contract paradigm has reshaped the questions that not-for-profit scholarship attempts to answers, and it is tightly linked to developments in not-for-profit doctrine and practice. Key examples include the growth of donor standing — the notion that not-for-profits have a fiduciary duty to their donors, and that donors may bring suit for breaches — and the growing obsession with “donor intent” throughout the not-for-profit sphere. I contrast contractarianism with an institutionalist “public trust” conception of charities, which was the prevailing intellectual paradigm for most of the 20th century.
Friday, June 12, 2020
Charitable organisations occupy a central place in society across much of the world, accounting for billions of pounds in revenue. As society changes, so does the law which regulates nonprofit organisations. From independent schools to foodbanks, they occupy a broad policy space. Not immune to scandals, sometimes nonprofits are in the news for all the wrong reasons and so, when they are in the public eye, regulators must respond to high profile cases.
In this book, a team of internationally recognised charity law experts offers a modern take on a fast-changing policy field. Through the concept of policy debates it moves the field forward, providing an important reference point for developing scholarship in charity law and policy. Each chapter explores a policy debate, setting out the fault-lines in play, and often offering proposals for reform.
Two important themes are explored in this edited collection. First, there is a policy tension in charity law between its largely conservative history and the need to keep up-to-date with social change. This pressure is felt acutely along key fault-lines, such as the extent to which a body of law which developed before the advent of legislated human rights is able to adapt to a rights-based world, and the extent to which independent schools – historically so closely linked with charity – might deserve their generous tax-breaks. The second theme explores the law from the perspective of a good-faith regulator, concerned to maximise the usefulness of charities. From the need to reform old organisations, to the need to ensure that charities enjoy the right amount of regulatory freedom in a world of payment-by-result contracts, the book critically charts the policy justifications for regulatory intervention, as well as the costs that such intervention might bring.
Debates in Charity Law will be of interest to both academic researchers and students of the non-profit sector, looking to understand the links between law, social change and regulation. It will also help and guide nonprofit employees and volunteers, showing how their sector is shaped and moulded by the law.
And here is the Table of Contents:
1. Fault Lines in Charity Law
John Picton and Jennifer Sigafoos
2. Independence and Accountability in the Charity Sector
3. Debating the Extent of Party/State Control Over Overseas Nonprofit Organisations: Charity Law Debates in China
4. Regulating Egoism in Perpetuity
5. Deploying Communitarianism Bankruptcy Theory to Rescue Insolvent Charities and Maintain Charitable Purposes
6. When Should Charities be Allowed to Discriminate? The Case of Single-Sex Services and Transgender People
7. Regulating Charitable Activities through the Requirement for Charitable Purposes: Square Peg Meets Round Hole
8. Redefining the Regulatory Space? Th e First Forays of the Irish Charities Regulatory Authority
Oonagh B Breen
9. Independent Schools in Scotland: Should they be Charities?
10. Licking their Own Lollipops: What do Charities and the Public Think about the Regulation of Charitable Activities?
11. Commissioning of Services by Charities in the Third Decade of the Contract Culture: Lessons Learned (or Not Yet)
12. Regulating the Digital (Currency) Revolution: Unravelling the Technological Challenge Faced by Charities
Matthew Robert Shillito
13. Social Housing – Charities and Vulnerable Groups
14. Charity Law and Policy: Looking Forward
Jennifer Sigafoos and John Picton
Tuesday, September 3, 2019
I found this helpful list of recommended nonprofit readings on the Chronicle of Philanthropy website:
I have read a few of them, have a couple of others on my Nook awaiting my attention (with summer reading time coming to an end and the new semester ... they may be waiting a while), and others that I'm about to add to the stack. I read Winner Take All - I think the central point was important, but found the author's approach to be so judgmental as to overwhelm his argument. I just started Just Giving, and am looking forward to finishing that as part of an article I'm writing (slowly...) on endowments. I think the next up will be Uncharitable.
I'd love to hear any thoughts others might have on these books, and if there are any that you all might add to the list.
Thursday, August 15, 2019
Update Available for Fishman, Schwarz, and Mayer Nonprofit Organizations: Cases and Materials (5th ed.)
For those of you who use the Nonprofit Organizations casebook I co-author with James J. Fishman (Pace) and Stephen Schwarz (Hastings, emeritus), a new Student Update Memorandum is available for download (at no charge to you or your students) and and a new Teacher's Manual Update Memorandum is also available (also at no charge, but requires a West Academic Account). Both are current through July 15, 2019, and so include discussions of all relevant provisions of the 2017 Tax Cuts and Jobs Act (TCJA) as well as guidance relating to those provisions. The Student Update Memorandum also includes the text of new provisions added by TCJA and the Bipartisan Budget Act of 2018, as well as the text of other changed or added provisions that are included in the Nonprofit Organizations Statutes, Regulations and Forms book that we also author.
As always, any feedback - positive or negative - regarding the casebook and the updates is greatly appreciated.
Friday, February 15, 2019
Ellen Aprill's Review of Hamburger's "Liberal Suppression: Section 501(c)(3) and the Taxation of Speech"
Ellen Aprill (Loyola-LA) recently posted a review of Professor Philip Hamburger's (Columbia) "Liberal Suppression: Section 501(c)(3) and the Taxation of Speech" at HistPhil.org. HistPhil, which is "a web publication on the history of the philanthropic and nonprofit sectors, with a particular emphasis on how history can shed light on contemporary philanthropic issues and practice." Prof. Hamburger's book argues that, as a constitutional law matter,
... theopolitical fears about the political speech of churches and related organizations underlay the adoption, in 1934 and 1954, of section 501(c)(3)’s speech limits. He thereby shows that the speech restrictions have been part of a broad majority assault on minority rights and that they are grossly unconstitutional.
Friday, February 8, 2019
This Research Handbook provides a comprehensive overview of scholarship on not-for-profit law. The chapters, written by world leading experts, explore key ideas and debates in relation to: theories of the not-for-profit sector, the composition and scope of that sector, not-for-profit organisations and the constitution, the legal conception of charity, the tax treatment of not-for-profit organisations and the regulation of not-for-profits. The book serves to represent not-for-profit law as a field of academic inquiry, and to point the way to future research in that field.
And here is the table of contents:
Part I Theories of the Not-for-Profit Sector
1. A Law and Economics Perspective on Nonprofit Organizations
Richard Steinberg and Brian Galle
2. A Primer on the Neo-Classical Republican Theory of the Non-Profit Sector (And the Other Three Sectors Too)
3. A Charity Law Perspective on a Liberal Perspective on Charity Law
4. The Not-for-Profit Sector: A Roman Catholic View
Fr Brian Lucas
Part II The Composition and Scope of the Not-for-Profit Sector
5. An Overview of the Not-for-Profit Sector
Myles McGregor-Lowndes OAM
6. The Boundary between Not-for-Profits and Government
7. The Boundary between the Not-for-Profit and Business Sectors: Social Enterprise and Hybrid Models
Benjamin M Leff
8. Donor Intention and Dialectic Legal Policy Frames
Part III Not-for-Profit Organisations and the Constitution
9. Not-for-Profit Organisations, Public Law and Private Law
10. Not-for-Profit Organisations and Equality Law
François du Toit
11. Charity Law and Freedom of Political Communication: the Australian Experience
12. Not-for-Profit Law and Freedom of Religion
Part IV The Legal Conception of Charity
13. The History and Future of the Law of Charity
G E Dal Pont
14. Charity in Common Law and Civilian Jurisdictions
Michael H Lubetsky
15. The Heads of Charity in Comparative Perspective
16. Public Benefit Post-Pemsel
Part V The Tax Treatment of Not-for-Profit Organisations
17. Taxation and the Not-for-Profit Sector Globally: Common Issues, Different Solutions
18. Subsidizing Charity Liberally
Miranda Perry Fleischer
19. Ways the Charitable Deduction Has Shaped the US Charitable Sector
20. The Major Tax Concessions Granted to Charities in Australia, New Zealand, England, the United States of America and Hong Kong: What Lessons Can We Learn?’
21. Reforming Tax Policy with Respect to Non-Profit Organisations
Part VI The Regulation of Not-for-Profit Organisations
22. Principles of Regulation of Not-for-Profits
23. Design and Implementation of a Charitable Regulation Regime
24. Redefining the Measure of Success: A Historical and Comparative Look at Charity Regulation
Oonagh B Breen
25. A Regulator’s View
Susan Pascoe AM
Thursday, October 25, 2018
Columbia Law School Professor Philip Hamburger is a prodigious and iconoclastic legal scholar. ... Hamburger’s latest subject, in Liberal Suppression ([University of Chicago Press] 2018), is an inquiry into the legitimacy of restrictions on the political speech of non-profit organizations. Section 501(c)(3) exempts religious, educational, and charitable organizations from federal income tax but denies them this exemption if they engage in campaign speech for or against any candidate for public office or devote a substantial part of their activities to propaganda or other attempts to influence legislation. Section 170(c) makes contributions to qualifying non-profits tax-deductible to the donor. According to Hamburger, these exemptions and deductions amount to “many billions of dollars annually.”
Most people’s knee-jerk reaction is that section 501(c)(3)’s restrictions are justified by the tax-exempt status such non-profit organizations applied for and received. Rejecting such preconceptions in his trademark fashion, Hamburger strongly disagrees. Although non-profits are free to express a wide range of opinions—even political opinions—outside of political contests, Hamburger views section 501(c)(3) as “an extraordinary abridgement of an essential freedom,” which ought to be considered unconstitutional. Inasmuch as the Supreme Court has unanimously upheld the lobbying restrictions in section 501(c)(3), Liberal Suppression is nothing if not ambitious, but is it persuasive? Realizing that his arguments may appear to be an “uphill struggle,” early on Hamburger asks readers to “hold their skepticism in abeyance.”
After reading the book, my skepticism remains stubbornly intact.
Hamburger reminds the reader that from colonial times until the amendment of section 501(c)(3) in 1934 (and further tightening in 1954, and again in 1987), which imposed the restrictions he finds objectionable, American clergy actively participated in politics from the pulpit. The timing of the 1934 and 1954 restrictions, he points out, coincides with a period of “liberal” anti-Catholic sentiment in America. The principal culprits in Hamburger’s tale are nativists such as Ku Klux Klan imperial wizard Hiram Evans and then-Senator Lyndon B. Johnson, who faced a Catholic opponent in the 1954 senatorial primary. Hamburger portrays them as the instigators of section 501(c)(3)’s “oppressive” political restrictions. ...
Does section 501(c)(3) “threaten the core of most First Amendment freedoms,” as Hamburger claims? Liberal Suppression, despite its undeniable erudition and interesting digressions into American political (and theological) thought and historical asides, falls short of making a compelling case. Hamburger is likewise unconvincing in his attempt to make a connection between the restrictions in section 501(c)(3) and contemporary forms of censorship such as campus speech codes. While Hamburger’s theoretical arguments seem to miss their mark, they are always engaging and sometimes contains gems like this:
"American religion has increasingly been aligned with popular liberal and progressive opinion—even to the point of looking for salvation not in another world but in this one, and not so much from God as from democratic government."
My new book, Liberal Suppression, argues that section 501(c)(3)’s speech restrictions are prejudiced and unconstitutional. These conclusions run counter to widespread assumptions, and it is therefore understandable that Mark Pulliam and other thoughtful readers find them difficult to stomach. All the same, it is important at least to come to grips with the realities that underlie the book’s conclusions, and Pulliam’s review fails to do this. To evaluate the prejudice, one must understand its nature; and to judge the constitutional arguments, one must recognize their breadth and strength.
The prejudice underlying section 501(c)(3) arose from theologically liberal anxieties about the speech of churches. And as traced by my book, the prejudice gradually expanded into a broader liberal fear about the speech of all sort of idealistic organizations. Indeed, these liberal concerns have expanded to include fears about the orthodox or stereotypical speech of individuals. It is therefore disappointing that Pulliam reduces my account of prejudice to a simplistic complaint about narrow anti-Catholicism.
My book, in his view, argues that section 501(c)(3) speech restrictions were added “in order to reduce the influence of the Catholic Church.” Certainly, anti-Catholicism was the opening wedge. But as my book repeatedly emphasizes, the relevant prejudices were not narrowly anti-Catholic. Already in the early nineteenth, they were broadened out to take aim at business corporations, and in the strain that is central to my book, they soon reached not only churches—Protestant as well as Catholic—but also the full range of churchy organizations, including eventually all sort of idealistic groups that were not religious. ...
[T]he prejudiced sentiment about the speech of ecclesiastical and other idealistic organizations is painfully evident in section 501(c)(3). Pulliam protests that I have not shown this. Well, consider just one phrase—the section’s limit on “carrying on propaganda, or otherwise attempting to influence legislation.” Those words were no accident. They came directly out of nativist literature—a literature that, again, reached across much of American society, from KKK klaverns to Ivy League philosophy departments. Once more, the low and the high had more in common than the latter wanted to acknowledge.
Pulliam’s review, in short, recognizes neither the broad character of the prejudice nor its societal depth. And in taking a confined view of both, he misunderstands the antagonisms that underlay section 501(c)(3) and still undergird a host of other speech restrictions. ...
Tax lawyers and First Amendment lawyers tend to have very different sensibilities about the speech restrictions. Tax lawyers usually observe that churches etc. are only slightly quieted down, for they can convey their messages through auxiliary organizations, such as section 501(c)(4) organizations and section 527 PACs. First Amendment doctrine, however, treats even the slightest restriction on political speech with apprehension. And the freedom of speech is not merely the freedom to have one’s message come out of someone else’s mouth; most basically it is the freedom to speak—to speak through one’s own mouth, in one’s own voice.
Unlike Pulliam, most Americans, on both sides of the issue, understand that section 501(c)(3) matters for speech. It is the only subsection of the Internal Revenue Code that is widely known—even by its section number—and that is no accident. The whole point of the section’s speech restrictions was to satisfy deeply felt theo-political anxieties about speech—anxieties that remain pervasive. And this is why so many Americans care. Whether they like or fear the speech of ecclesiastical and other idealistic organizations, they understand that section 501(c)(3) chills such groups.
[Hat tip: TaxProf Blog]
Sunday, February 25, 2018
I missed this last fall, but Joel L. Fleishman (Duke) has written a new book, Putting Wealth to Work: Philanthropy for Today or Investing for Tomorrow? Here is the abstract:
By 2025, Americans will likely be donating over half a trillion dollars annually to nonprofit organizations. Those philanthropic gifts will transform significant parts of America’s civic sector landscape.Philanthropy is entering an era of unprecedented growth and innovation. Established foundations such as Ford and Rockefeller are doubling down on programs tackling long-simmering problems, including global inequality, less-than-stellar education, and uneven access to health care. Many foundations are engaging in advocacy on controversial issues, exploring venture philanthropy solutions, and experimenting with impact investing. And philanthropists such as Bill Gates, Warren Buffett, New York’s high-profile financiers, and Silicon Valley’s billionaires are planning to put their wealth to work as never before: Mark Zuckerberg and Priscilla Chan recently pledged to donate 99 percent of their Facebook shares during their lifetimes, and nearly 150 others have signed the Giving Pledge to increase dramatically their “giving while living.”In Putting Wealth to Work, Joel L. Fleishman provides expert analysis of contemporary philanthropy, offering invaluable insight for those engaging with and affected by charitable foundations. This is the fascinating and definitive account of philanthropy today, and an indispensable guide to understanding its inner workings, impact, and expansive potential.
I have posted Fiduciary Principles in Charities and Other Nonprofits, which will be published in The Oxford Handbook of Fiduciary Law (Evan J. Criddle, Paul B. Miller, and Robert H. Sitkoff, eds.). Here is the abstract:
This book chapter provides an overview of the fiduciary principles that apply to charities and other nonprofit organizations. More specifically, it discusses the criteria that trigger a fiduciary relationship, the duties of loyalty and care, other legal obligations that may apply to nonprofit fiduciaries, and the extent to which those duties and obligations may be modified or avoided. In the course of doing so, it discusses and critiques the approaches taken to these principles by the draft Restatement of the Law, Charitable Nonprofit Organizations.
Wednesday, September 3, 2014
For those who use Jim Fishman and Steve Schwarz's casebook, Nonprofit Organizations, Cases and Materials (4th ed. 2010), the 2014 Student Update is available here and 2014 Teacher's Manual Update is available here (instructor login required). (Full disclosure: I collaborated on these updates.)
Sunday, April 27, 2014
Cass Brewer (Georgia State) has posted Gift Horses, Choosy Beggars, and Other Reflections on the Role and Utility of Social Enterprise Law. Here is the abstract:
The U.S. law of social enterprise is growing rapidly. Since 2008, one-half of all U.S. states have modified their business law to establish special legal forms designed for social enterprise. Meanwhile, even with twenty-five states adopting special laws for social enterprise, the legal debate surrounding social enterprise continues. Rather than rehashing that debate, this essay sets forth the author’s personal perspective on the role and utility of social enterprise. The essay argues that, except in limited circumstances, social enterprise is superior to traditional philanthropy when it comes to solving longstanding humanitarian or environmental problems. U.S. business law thus should continue to evolve to facilitate social enterprise.
He also is a co-author (with Elizabeth Carrott Minnigh and Robert Wexler) for the just released BNA Tax Management Portfolio Social Enterprise by Non-Profits and Hybrid Organizations, No. 489-1st.
Monday, August 3, 2009
Last week's Wall Street Journal had an interesting op-ed piece reviewing Steven Goldberg's new book, "Billions in Drops in Millions of Buckets." The book makes the assertion, essentially, that the nonprofit sector is just as inefficient as government (if not more) in solving social problems precisely because of the lack of sector "government:"
But what about America’s nonprofit sector—organizations that concentrate their efforts on exactly such problems, with money from charities, trusts and personal philanthropies? They too spend enormous sums. Is their record any better? Not really, says Steven H. Goldberg in “Billions of Drops in Millions of Buckets.” We should not, he cautions, blame the American character for this failure: There is plenty of compassion and generosity to go around. Nor is bad thinking at fault: There are plenty of bright ideas and innovative programs. No, it is the whole structure of giving that condemns even the best efforts: We collect and spend our charitable dollars in a haphazard and fragmented way, he argues, diluting whatever problem-solving force they may have.
The reviewer, William A. Schambra, takes issue with the book's essential points. My reaction was based more on the irony of the assertion, to wit: "government is inefficient because it is too regimented and nonprofit is inefficient because it is insufficiently regimented.
Monday, February 23, 2009
This essay, a revised version of which will appear in the Research Handbook on Human Rights (Edward Elgar, forthcoming 2009), attempts to systematize NGO activity relating to human rights. It first describes why human rights supplies fertile ground for the study of non-governmental organizations. As human rights obligations cannot be explained in terms of reciprocal state interest, non-state actors are a probable causal agent in the entrenchment of human rights regimes. The chapter confronts NGOs as agents of material power. The chapter then describes four primary pathways for the exercise of NGO power: through and against states, international organizations, corporations, and each other. Only by situating NGO power relative to state and non-state entities does the breadth and novelty of NGO participation in today's global decision-making come into full relief. Given the fact of that broad power, the chapter concludes by addressing the question of NGO accountability, suggesting that institutionalization of NGO power holds the most promise for appropriately constraining its exercise.
Friday, March 21, 2008
Alex Espenkotter and Jennifer Facarazzo published Administration of Trusts in Florida: Charitable Trusts (Ch. 16). Here is the introduction:
Charitable trusts are excellent vehicles for persons with philanthropic intentions to effectively give money to their favorite charitable causes while obtaining valuable tax benefits. Not to be overlooked, however, is the need for proper implementation and administration of these entities. “[F]or the estate planning attorney, [trustee,] and financial planner, a thorough study of the issues surrounding charitable... trusts is an imperative to their successful utilization.” Callister, Charitable Remainder Trusts: An Overview, 51 Tax Law. 549, 569 (1998). This chapter addresses various aspects of charitable trust formation and administration.
Initially, the discussion focuses on the numerous specific federal requirements and restrictions that must be followed and adhered to for proper administration of charitable trusts. The various types of charitable remainder trusts and charitable lead trusts are discussed in detail. Next, the chapter discusses the payment of annuity and unitrust amounts under various charitable trust arrangements. Thereafter, the availability of the charitable deduction and its computation is covered. Following that is a discussion of the income tax consequences associated with various charitable trusts. The focus then shifts to application of the private foundation rules to charitable trusts. The chapter concludes by addressing the duties and powers of trustees and the compensation for trustees and attorneys of charitable trusts. These latter two subjects are also discussed in depth in Chapters 2 and 13, respectively, of this manual. For a discussion of the modification of charitable trusts, see §8.16 of this manual.
For the entire chapter, see Administration of Trusts in Florida: Charitable Trusts (Ch. 16) (available at the Florida Bar website CLE section).
Tuesday, March 18, 2008
On March 14, 2008, the St. Louis Post-Dispatch published an article about a new book - "Forces of Good" by Leslie Crutchfield and Heather McLeod Grant - on the six best practices for nonprofit organizations. Here is an excerpt from the text of the article:
• Advocate and serve. Crutchfield and Grant say the best in the world of nonprofits bridge the divide between service and advocacy. An example is the expansion of a North Carolina agency call Self-Help. It started as an agency assisting the needy in building houses and grew to become a powerful advocate for predatory-lending policy reforms across the country.
• Making markets work. Nonprofits succeed when they embrace an entrepreneurial spirit. Often disavowed by nonprofits, Environmental Defense partnered with fast-food giant McDonalds. The result was a dramatic reduction of the company's solid wastes by encouraging the switch to environmentally friendly materials.
• Inspire evangelism. This is done when volunteers see their role beyond fundraising and advice to that of missionaries helping sustain the group's mission. Habitat for Humanity exemplifies this through its meteoric rise from local Georgia roots to a global organization with a $1 billion budget that has successfully mobilized the public worldwide.
• Nurture nonprofit networks. Collaboration is not a common practice among nonprofits and yet the authors are emphatic that the best nonprofits thrive when they share their wealth, expertise and talents with their peers. The Exploratorium in San Francisco is cited for its collaborative success from its informal network.
• Master the art of adaptation. Demonstrating the willingness to make drastic changes to affect the overall goals of an organization is key to nonprofit success. Share Our Strength switched from direct mail to special events for fundraising, yielding extraordinary results for the organization.
• Share leadership. Recognized as one of the attributes that is paramount to becoming a force for good, sharing leadership is more about developing others and a team orientation within the organization and even the board.
For the entire article, see "Finally, the 'Good to Great Book' for non-profits" in the March 14, 2008, issue of the St. Louis Post-Dispatch.
Monday, December 10, 2007
In December 2007, Professor Sidney Watson (St. Louis) published a law review article that contains reviews of two recently published books - Jonathan Engel's Poor People's Medicine: Medicaid and American Charity Care Since 1965 (Durham, NC: Duke Univ. Press, 2006) and Ronald J. Angel's Poor Families in America's Health Care Crisis (New York, NY: Cambridge Univ. Press, 2006). Here is the introductory paragraph of the article:
Two new books examine Medicaid--one from a historical perspective and the other through a socioanthropological lens. Poor People's Medicine offers the view from the top: a history of Medicaid and charity care that focuses primarily on national policy developments. Poor Families in America's Health Care Crisis offers the view from the bottom: ethnographic interviews of poor families who discuss Medicaid and charity care from their vantage point at the bottom of the economy. Both books acknowledge Medicaid's many successes in improving access to medical care and the health status of America's poor, yet each reveals how America's deep and long-standing ambivalence toward the poor has produced a deeply flawed Medicaid program.
To see the full article, go to Journal of Health Politics, Policy and Law at 32 J. Health Pol. Pol'y & L. 1053.