Journal of Health Politics Policy and Law最新文献

Paid Leave for Personal and Family Illness: Impacts of State Policy Design on Coverage and Access by Race, Gender, and Education Level. 个人和家庭疾病带薪休假：国家政策设计对种族、性别和教育水平覆盖和获取的影响。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-03 DOI: 10.1215/03616878-11856131

Aleta Sprague, Alison Earle, Amy Raub, Firooz Kabir, Michael McCormack, Jody Heymann

{"title":"Paid Leave for Personal and Family Illness: Impacts of State Policy Design on Coverage and Access by Race, Gender, and Education Level.","authors":"Aleta Sprague, Alison Earle, Amy Raub, Firooz Kabir, Michael McCormack, Jody Heymann","doi":"10.1215/03616878-11856131","DOIUrl":"https://doi.org/10.1215/03616878-11856131","url":null,"abstract":"Context: Paid leave for serious personal and family illnesses can significantly improve health outcomes. With no federal paid family and medical leave (PFML) policy, states are increasingly adopting their own. Yet eligibility criteria for paid leave and job protection, alongside benefit adequacy, vary markedly across states, affecting coverage and equity.Methods: We developed a database of state-level paid leave policies to systematically analyze each state's eligibility criteria for leave and job protection. We applied the policy database's detailed criteria to employment data from the U.S. Current Population Survey Annual Social and Economic Supplement to analyze eligibility by race/ethnicity, gender, and education. We measured benefit adequacy by analyzing whether family income would drop below the federal poverty threshold during a worker's leave.Findings: Minimum earnings, tenure, and hours rules disproportionately exclude workers with less education and women from paid leave and/or job protection. Minimum firm size disproportionately excludes workers with less education and Latinx workers from job protection. Black and Latinx workers' family income is more likely to fall below poverty during leave.Conclusions: State-level PFML has expanded coverage in the absence of a federal policy. Lowering or eliminating minimum firm size, tenure, and hours requirements; raising wage replacement rates; and ensuring full job protection would reduce remaining gaps and inequities.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analyzing Public Support for School-Based Mental Health Services. 分析公众对校本心理健康服务的支持。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-03 DOI: 10.1215/03616878-11853748

Nicholas Hemauer, Seth Warner

{"title":"Analyzing Public Support for School-Based Mental Health Services.","authors":"Nicholas Hemauer, Seth Warner","doi":"10.1215/03616878-11853748","DOIUrl":"https://doi.org/10.1215/03616878-11853748","url":null,"abstract":"Context: Public schools play a central role in addressing the mental health crisis among American youth, but most schools are limited in the services they provide. As of 2019, 44% of administrators cited concerns about the public's reaction as an obstacle to expanding these services.Methods: We draw on observational data from three national surveys to study the individual-level characteristics that are associated with support for these programs. Then, we use a conjoint experiment, which randomly varies the details of a proposal at a hypothetical school board meeting to identify the programs, policies, and contexts that are most likely to gain the public's support.Results: We find support for school mental health programs to be higher for women, racial minorities, younger people, and Democrats. The conjoint experiment results suggest that school mental health services receive more support when they are funded via state as opposed to local taxes, and when parental permission is required to participate.Conclusions: The results offer guidance for policymakers, emphasizing high overall public support for school mental health services, while highlighting key factors that may facilitate their implementation and acceptance.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

It's Only a Crisis if It's Fit to Print: Examining the Relationship Between Overdose Rates, News Coverage, and the Presence of the Opioid Crisis in State Legislative Campaigns. 只有适合印刷的才是危机：检查过量率，新闻报道和州立法运动中阿片类药物危机存在之间的关系。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-03 DOI: 10.1215/03616878-11853740

Rachael L M Erickson, Joshua Meyer-Gutbrod

{"title":"It's Only a Crisis if It's Fit to Print: Examining the Relationship Between Overdose Rates, News Coverage, and the Presence of the Opioid Crisis in State Legislative Campaigns.","authors":"Rachael L M Erickson, Joshua Meyer-Gutbrod","doi":"10.1215/03616878-11853740","DOIUrl":"https://doi.org/10.1215/03616878-11853740","url":null,"abstract":"Context: The modern opioid epidemic has been an increasingly prominent issue within the national media, culminating in significant attention during the 2016 and 2020 national elections, with non-uniform campaign attention at the state level. This paper explores the driving factors in this disparity, examining how public perception of the opioid crisis is shaped by its associated deaths and coverage of the issue in local media.Methods: We model the presence of opioid policy and rhetoric in state legislative campaigns against both the abundance state-level news coverage and recorded overdose rates, including key controls for important demographic variables.Findings: We find that news attention is the strongest predictor of campaign attention in state level campaigns. Further, while news media and actual overdose deaths can have a reinforcing effect, increasing candidate attention to an issue, media attention can also influence candidates through framing, encouraging increase attention in particular communities framed as major concerns within the media.Conclusions: These results contribute to our understanding of opioid reform at the state level and speak to the impact of news media in both raising awareness and shaping frames about even highly salient issues in public health and beyond.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medicaid and the Great Unwinding: The Administrative Presidency Meets Federalism. 医疗补助和大放松：行政总统制与联邦制。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-03 DOI: 10.1215/03616878-11859429

Michael K Gusmano, Frank J Thompson

引用次数: 0

Hospital Consolidation Across Geographic Markets: Insights from Market Participants on Mechanisms for Price Increases. 跨地域市场的医院合并：市场参与者对提价机制的见解。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-03 DOI: 10.1215/03616878-11853756

Katherine Gudiksen, Andréa E Cabellero, Paul Ginsburg, Bruce Allain, Thomas Greaney, Brent D Fulton

{"title":"Hospital Consolidation Across Geographic Markets: Insights from Market Participants on Mechanisms for Price Increases.","authors":"Katherine Gudiksen, Andréa E Cabellero, Paul Ginsburg, Bruce Allain, Thomas Greaney, Brent D Fulton","doi":"10.1215/03616878-11853756","DOIUrl":"https://doi.org/10.1215/03616878-11853756","url":null,"abstract":"Context: Consolidation among health systems has resulted in increased prices and caused the cost of employer-sponsored health benefits to increase much faster than inflation over the past few decades. Prior quantitative research demonstrates small, but significant price increases resulting from transactions that expand the geographic footprint of health systems, but the mechanisms by which these cross-market acquisitions raise prices is not completely resolved.Methods: In this qualitative study, we interview market participants to elucidate the experience of employers, insurers, and others when negotiating with large health systems.Findings: The respondents report employer demand for broad, stable provider networks and a lack of support from employers for insurers when negotiating with large health systems undermined insurers' ability to negotiate lower prices. Additionally, the interviews identified the widespread use of restrictive contract terms by health systems and misaligned financial incentives between employers and consultants engaged to act on their behalf.Conclusions: Without government action, employers will be unable to restrain price increases that result from increasing market power of consolidated health systems. We identify policy levers that regulators can use to increase competition, but the oligopolistic nature of many health care markets in the U.S. suggest that even more significant government action may be needed.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Public Health Insurance Coverage for Immigrants during Pregnancy, Childhood, and Adulthood: A Discussion of Relevant Policies and Evidence. 孕期、儿童期和成年期移民的医疗补助/医疗保险覆盖范围：相关政策和证据讨论》。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-01 DOI: 10.1215/03616878-11567684

Laura R Wherry, Rachel E Fabi, Maria W Steenland

{"title":"Public Health Insurance Coverage for Immigrants during Pregnancy, Childhood, and Adulthood: A Discussion of Relevant Policies and Evidence.","authors":"Laura R Wherry, Rachel E Fabi, Maria W Steenland","doi":"10.1215/03616878-11567684","DOIUrl":"10.1215/03616878-11567684","url":null,"abstract":"Context: Despite major expansions in public health insurance under Medicaid and the Children's Health Insurance Program over the last 60 years, many immigrants remain ineligible for coverage.Methods: The authors discuss the existing federal and state policies that extend public health eligibility to low-income pregnant immigrants, children, and nonelderly adults. They also conduct a literature review and summarize quasi-experimental evidence examining the impact of public health insurance eligibility expansions on insurance coverage, health care use, and health outcomes among immigrants.Findings: Public health insurance eligibility for immigrants varies widely across states because of the implementation of different federal and state policy options. Previous studies on expanded eligibility identified positive effects on insurance coverage and health care utilization among pregnant and child immigrants as well as some evidence indicating improved health outcomes. Additional research is required to understand the longer-term impacts of expanded coverage and to examine impacts of recent state expansions for adults.Conclusions: A complicated patchwork of federal and state policies leads to major differences in immigrant access to publicly funded insurance coverage across states and population groups. These policies likely have important implications for immigrant access to health care and health.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"283-306"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rationing Rights: Administrative Burden in Medicaid Long-Term Care Programs. 权利配给：医疗补助长期护理计划的行政负担。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-01 DOI: 10.1215/03616878-11567708

Pamela Herd, Rebecca A Johnson

{"title":"Rationing Rights: Administrative Burden in Medicaid Long-Term Care Programs.","authors":"Pamela Herd, Rebecca A Johnson","doi":"10.1215/03616878-11567708","DOIUrl":"10.1215/03616878-11567708","url":null,"abstract":"Context: States use Medicaid waivers to provide supports for disabled people in communities rather than in institutions. Because waivers are not entitlements, those deemed eligible are not guaranteed these supports. How do states, in practice, use bureaucratic procedures to ration this \"conditional\" right?Methods: Drawing on primary and secondary data, the authors analyze waiver programs and document state administrative procedures that indirectly and directly ration access.Findings: Burdens indirectly limit disabled people's access to Medicaid home- and community-based services via a complex array of waiver programs that exacerbate costs associated with gaining eligibility. In addition, burdens directly limit access via wait lists and prioritization among the eligible. There is also evidence that states strategically deploy opaqueness to provide political cover for unpopular wait lists. The overall process is opaque, confusing, and time intensive, with burdens falling hardest on marginalized groups.Conclusions: Administrative burdens impede disabled people's efforts to exercise their right to live in the community as afforded to them under the American with Disabilities Act. The opaqueness and associated burdens with waiver programs are a way to conceal these burdens, thereby demonstrating how burdens \"neatly carry out the 'how' in the production of inequality, while concealing . . . the why\" (Ray, Herd, and Moynihan 2023: 139).","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"223-251"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Building Power for Health: The Grassroots Politics of Sustaining and Strengthening Medicaid. 为健康积聚力量：维持和加强医疗补助计划的基层政治》（The Grassroots Politics of Sustaining and Strengthening Medicaid.

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-01 DOI: 10.1215/03616878-11567668

Jamila Michener

{"title":"Building Power for Health: The Grassroots Politics of Sustaining and Strengthening Medicaid.","authors":"Jamila Michener","doi":"10.1215/03616878-11567668","DOIUrl":"10.1215/03616878-11567668","url":null,"abstract":"Context: Notwithstanding an impressive corpus charting the politics of Medicaid, there is still much to learn about the contemporary politics of sustaining, expanding, and protecting the program. There is especially scant scholarly evidence on the significance and function of grassroots political actors (i.e., the communities and groups most directly affected by health policy). This article explores the role such groups play in the politics of Medicaid.Methods: This research is based on qualitative interviews with organizers and advocates working in the domain of health policy.Findings: The power of grassroots actors in Medicaid politics is constrained by political and structural forces, including philanthropic funding practices, racism, and partisan polarization. Nevertheless, when bottom-up actors effectively exercise power, their involvement in Medicaid politics can transform policy processes and outcomes.Conclusions: Grassroots actors-those who are part of, represent, organize, or mobilize the people most affected by Medicaid policy-can play pivotal roles within Medicaid politics. Although they do not yet have sufficient political wherewithal to consistently advance transformational policy change, ongoing political processes suggest that they hold promise for being an increasingly important political force.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"189-221"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Closing Gaps or Holding Steady? The Affordable Care Act, Medicaid Expansion, and Racial Disparities in Coverage, 2010-2021. 缩小差距还是保持稳定？平价医疗法案》、《医疗补助扩展》和种族覆盖差异，2010-2021 年。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-01 DOI: 10.1215/03616878-11567660

Benjamin D Sommers, Rebecca Brooks Smith, Jose F Figueroa

{"title":"Closing Gaps or Holding Steady? The Affordable Care Act, Medicaid Expansion, and Racial Disparities in Coverage, 2010-2021.","authors":"Benjamin D Sommers, Rebecca Brooks Smith, Jose F Figueroa","doi":"10.1215/03616878-11567660","DOIUrl":"10.1215/03616878-11567660","url":null,"abstract":"Context: Medicaid expansion under the Affordable Care Act (ACA) produced major gains in coverage. However, findings on racial and ethnic disparities are mixed and may depend on how disparities are measured. This study examines absolute and relative changes in uninsurance from 2010 to 2021 by race and ethnicity, stratified by Medicaid expansion status.Methods: The sample included all respondents younger than age 65 (N = 30,339,104) from the American Community Survey, 2010-21. Absolute and relative differences in uninsurance, compared to white Non-Hispanic individuals, were calculated for individuals who were Hispanic; Black; Asian American, Pacific Islander, and Native Hawaiian (AANHPI); American Indian and Alaska Native (AIAN); and multiracial. States were stratified into ever-expanded versus nonexpansion status.Findings: After the ACA, three patterns of coverage disparities emerge. For Hispanic and Black individuals, relative to white individuals, absolute disparities in uninsurance declined, but relative disparities were largely unchanged in both expansion and nonexpansion states. For AANHPI individuals, disparities were eliminated entirely in both expansion and nonexpansion states. For AIAN individuals, disparities declined in absolute terms but grew in relative terms, particularly in expansion states.Conclusions: All groups experienced coverage gains after the ACA, but changes in disparities were heterogeneous. Focused interventions are needed to improve coverage rates for Black, Hispanic, and AIAN individuals.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"253-281"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medicaid's Political Development since 1965: How a Fragmented and Unequal Program Has Expanded. 医疗补助自 1965 年以来的政治发展：一个支离破碎且不平等的计划是如何发展壮大的？

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-04-01 DOI: 10.1215/03616878-11567692

Colleen M Grogan

{"title":"Medicaid's Political Development since 1965: How a Fragmented and Unequal Program Has Expanded.","authors":"Colleen M Grogan","doi":"10.1215/03616878-11567692","DOIUrl":"10.1215/03616878-11567692","url":null,"abstract":"The Medicaid program has changed enormously over the past 60 years from a very restrictive program primarily attached to recipients on public assistance in 1965 to a much more expansive program today allowing coverage for persons regardless of marital, parental, or employment status. Incorporating the \"medically needy\"-an ambiguous concept from the start-allowed states to include many different groups in Medicaid who are not traditionally thought of as poor. In addition, three structural features illuminate why the program has expanded and changed dramatically over time: federalism and intergovernmental financing, the dominance of the private sector, and fragmentation. Unequal treatment among Medicaid-covered groups alongside partisan politics create a political discourse that often reveals Medicaid as a public subsidy for stigmatized groups while hiding Medicaid's reach into the middle class. This central political ideological tension collides with programmatic realities such that Medicaid strangely often suffers from a residual retrenchment politics while at the same time benefiting from embeddedness, making it extremely difficult to truly turn back the clock on Medicaid's expansion.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":"137-164"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0