Journal of Health Politics Policy and Law最新文献

Medicaid/CHIP 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 : 2024-09-27 DOI: 10.1215/03616878-11567684

Laura Wherry, Rachel Fabi, Maria Steenland

{"title":"Medicaid/CHIP Coverage for Immigrants During Pregnancy, Childhood, and Adulthood: A Discussion of Relevant Policies and Evidence.","authors":"Laura Wherry, Rachel Fabi, Maria Steenland","doi":"10.1215/03616878-11567684","DOIUrl":"https://doi.org/10.1215/03616878-11567684","url":null,"abstract":"Context: Despite major expansions in public health insurance under Medicaid and CHIP over the last 60 years, many immigrants remain ineligible for coverage.Methods: We discuss the existing federal and state policies that extend public health eligibility to low-income pregnant immigrants, children, and nonelderly adults. We also conduct a literature review and summarize quasi-experimental evidence examining the impact of public health insurance eligibility expansions on insurance coverage, healthcare use, and health outcomes among immigrants.Findings: Public health insurance eligibility for immigrants varies widely across states due to the implementation of different federal and state policy options. Previous studies on expanded eligibility identified positive effects on insurance coverage and healthcare utilization among pregnant and child immigrants, as well as some evidence indicating improved health outcomes. Further research is required to understand the longer-term impacts of expanded coverage, as well as to examine impacts of recent state expansions for adults.Conclusions: A complicated patchwork of federal and states 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 healthcare and health.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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 : 2024-09-27 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":"https://doi.org/10.1215/03616878-11567668","url":null,"abstract":"Context: Notwithstanding an impressive corpus charting the politics of Medicaid, we have 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 paper 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.Conclusion: Grassroots actors-those who are part of, represent, organize, or mobilize people most affected by Medicaid policy-can play pivotal roles within Medicaid politics. While 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":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","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

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 : 2024-09-27 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":"https://doi.org/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, we analyze waiver programs, and document state administrative procedures to indirectly and directly ration access.Findings: Burdens indirectly limit disabled peoples' access to Medicaid home and community-based services, via a complex array of waiver programs that exacerbate costs associated with gaining eligibility, and directly limit access, via waitlists and prioritization among the eligible. There is also evidence that states strategically deploy opaqueness to provide political cover for unpopular waitlists. The overall process is opaque, confusing, and time intensive, with burdens falling hardest on marginalized groups.Conclusions: Administrative burdens impede the right to live in the community afforded to people with disabilities under the American with Disabilities Act. The opaqueness and associated burdens with waiver programs are a way to conceal these costs, thereby demonstrating how burdens \"neatly carry out the 'how' in the production of inequality, while concealing . . . the why.\"","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","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

Closing Gaps or Holding Steady? The Affordable Care Act, Medicaid Expansion, & 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 : 2024-09-27 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, & Racial Disparities in Coverage, 2010-2021.","authors":"Benjamin D Sommers, Rebecca Brooks Smith, Jose F Figueroa","doi":"10.1215/03616878-11567660","DOIUrl":"https://doi.org/10.1215/03616878-11567660","url":null,"abstract":"Context: The Affordable Care Act's (ACA) Medicaid expansion 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 both absolute and relative changes in uninsurance from 2010-2021 by race and ethnicity, stratified by Medicaid expansion status.Methods: The sample contained all respondents under age 65 (N = 30,339,104) from the American Community Survey, 2010-2021. Absolute and relative differences in uninsurance, compared to White Non-Hispanic individuals, were calculated for Hispanic; Black; Asian-American, Pacific Islander and Native Hawaiian (AANHPI); American Indian and Alaska Native (AIAN); and multiracial individuals. States were stratified into ever-expanded vs. non-expansion 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 non-expansion states. For AANHPI individuals, disparities were eliminated entirely in both expansion and non-expansion states. For AIAN individuals, disparities declined in absolute terms but grew in relative terms, particularly in expansion states.Conclusions: All groups experienced coverage gains post-ACA, but with heterogeneity in changes in disparities. 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":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","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 : 2024-09-27 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":"https://doi.org/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 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":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","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

Policy Feedbacks and Medicaid on its 60th Anniversary. 政策反馈和医疗补助计划 60 周年。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-09-27 DOI: 10.1215/03616878-11567676

Andrea Louise Campbell

{"title":"Policy Feedbacks and Medicaid on its 60th Anniversary.","authors":"Andrea Louise Campbell","doi":"10.1215/03616878-11567676","DOIUrl":"https://doi.org/10.1215/03616878-11567676","url":null,"abstract":"Context: Despite early skepticism about Medicaid's ability to withstand retrenchment as a program of \"welfare medicine,\" it has proved remarkably durable. Existing analyses explain durability with a policy feedbacks perspective - how program provisions affect the subsequent political environment and policymaking options. This article updates earlier feedback accounts to the ACA era.Methods: Examines extant findings on policy feedbacks in Medicaid at the elite and mass levels since the implementation of the Affordable Care Act of 2010.Findings: Mass feedbacks have been modest. Medicaid expansion under the ACA only slightly increased beneficiary political participation, if at all. Medicaid attitudes among beneficiaries and the larger public have become somewhat more supportive. Elite-level feedbacks are the most powerful, with the federal contribution, increased for expansion populations under the ACA, inexorably shaping state incentives. However, continued rejection of Medicaid expansion and attempts to add conditions to Medicaid eligibility in Republican-led states with large shares of Black residents demonstrate that federalism, race, and the program's welfare medicine image continue to threaten the program.Conclusion: Medicaid survives as the nation's largest health insurance program by enrollment, and is deeply woven into the health care system, but remains chronically vulnerable and variable across states despite robust aggregate enrollment and spending.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332629","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

Entrenched Opportunity: Medicaid, Health Systems, and Solutions to Homelessness. 根深蒂固的机会：医疗补助、医疗系统和无家可归问题的解决方案。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-09-27 DOI: 10.1215/03616878-11567700

Charley Willison, Naquia Unwala, Katarzyna Klasa

{"title":"Entrenched Opportunity: Medicaid, Health Systems, and Solutions to Homelessness.","authors":"Charley Willison, Naquia Unwala, Katarzyna Klasa","doi":"10.1215/03616878-11567700","DOIUrl":"https://doi.org/10.1215/03616878-11567700","url":null,"abstract":"Context: As inequality grows, politically powerful healthcare institutions - namely Medicaid and health systems - are increasingly assuming social policy roles, particularly solutions to housing and homelessness. Medicaid and health systems regularly interact with persons experiencing homelessness who are high utilizers of emergency health-services, and experience frequent loss of/inability to access Medicaid services, resulting from homelessness. This research examines Medicaid and health system responses to homelessness, why they may work to address homelessness, and the mechanisms by which this occurs.Methods: Primary data were collected from Medicaid policies and the 100 largest health systems and national survey data from local homeless policy systems to assess scope, and measure mechanisms and factors influencing decision-making.Findings: Nearly one-third of states have Medicaid Waivers targeting homelessness and over half of the 100 largest health systems have homeless mitigation programs. Most Medicaid Waivers use local homeless policy structures as implementing entities. A plurality of health systems rationalize program existence based on the failure of existing structures.Conclusions: Entrenched healthcare institutions may bolster local homeless policy governance mechanisms and policy efficacy. Reliance on health systems as alternative structures, and implementing entities in Medicaid Waivers, may risk shifting homeless policy governance and retrenchment of existing systems.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332625","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 at 60. 医疗补助，第 60 页。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-09-27 DOI: 10.1215/03616878-11584279

Eric M Patashnik

引用次数: 0

Political Partisanship, Confucian Collectivism, and Public Attitudes toward the Vaccination Policy in Taiwan. 台湾的政治党派、儒家集体主义与公众对疫苗接种政策的态度。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-08-09 DOI: 10.1215/03616878-11513094

Ming-Jui Yeh, Yu-Chun Hsieh

{"title":"Political Partisanship, Confucian Collectivism, and Public Attitudes toward the Vaccination Policy in Taiwan.","authors":"Ming-Jui Yeh, Yu-Chun Hsieh","doi":"10.1215/03616878-11513094","DOIUrl":"https://doi.org/10.1215/03616878-11513094","url":null,"abstract":"Context: Conventional wisdom suggests that people with a collectivist tradition tend to comply more with the government's regulatory and even coercive disease-prevention policies. Besides this socio-cultural element, political partisanship is also an important aspect relating to people's willingness to cooperate with the government. This study aims to examine the relationships between these two factors and three dimensions of vaccination policy attitudes: common responsibility to take the vaccine, the government's vaccine mandate, and indignation over anti-vaxxers.Methods: Using the data from a nationally representative cross-sectional survey conducted in 2022 in Taiwan, this study applies multiple linear OLS regression to examine the relationships between vaccination policy attitudes and Confucian collectivism and political partisanship.Findings: Confucian collectivism and political partisanship aligning with the ruling party are associated with supportive vaccination policy attitudes. For those who do not align with the ruling party, the negative attitudes toward the vaccination policy appear in different dimensions according to the party they lean to.Conclusions: Confucian collectivism is prevalent in Taiwan and is related to public attitudes toward vaccination policy. This association is independent of political partisanship. Public health authorities should consider the socio-cultural context and political atmosphere for the effectiveness of disease-prevention measures.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908344","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

Pandemic Times and Health Care Exclusion: Attitudes Toward Health Care Exclusion of Undocumented Immigrants. 大流行时期与医疗排斥：对无证移民医疗排斥的态度。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2024-08-09 DOI: 10.1215/03616878-11513062

Cesar Vargas Nunez

{"title":"Pandemic Times and Health Care Exclusion: Attitudes Toward Health Care Exclusion of Undocumented Immigrants.","authors":"Cesar Vargas Nunez","doi":"10.1215/03616878-11513062","DOIUrl":"https://doi.org/10.1215/03616878-11513062","url":null,"abstract":"Context: Most of the 11 million undocumented immigrants living in the United States are excluded from government healthcare programs. Yet, healthcare inequities pose significant dangers to all members of society during a pandemic. This project explores to what extent undocumented immigrants, in the context of a pandemic, can be seen as deserving of access to government healthcare programs.Methods: The first survey experiment explores whether work ethic can affect perceptions of undocumented immigrants as deserving of government healthcare programs. The second survey experiment tests to what extent appeals to fairness and self-interest, during a pandemic, shape healthcare deservingness attitudes.Findings: The results show that respondents view undocumented immigrants as less deserving of healthcare than citizens, even when undocumented immigrants have a solid work history. The second survey experiment, however, shows that appeals to fairness and self-interest trigger substantial increases in support for undocumented immigrants, both among Republicans and Democrats.Conclusions: The results suggest that while undocumented immigrants are seen as less deserving of access, appeals to fairness and self-interest can trigger increased support.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908343","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