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In the realm of representational politics, research exploring the relationship between descriptive representation and substantive representation is conflicted with some scholars finding policy outcomes influenced by the presence of women in office and others displaying a complicated or null relationship. We enter the discussion by investigating the effect of increased representation of women across state legislatures on state health care spending for poor children, the disabled, and elders, issues which disproportionately affect women. Using a 50-state dataset spanning from 1999 to 2009 we find that spending is indeed more generous when the number of women representatives is substantial, regardless of party. This generosity, however, is conditional upon the presence of considerable aggregate need. The findings suggest that contextual factors must be considered when exploring the influence of women on policy outcomes.

The Influence of Women Legislators on State Health Care Spending for the Poor