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.

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.

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.

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.

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":"","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

Medicare in Treacherous Markets: From Community Bake Sales to Private Equity.

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-02-28 DOI: 10.1215/03616878-11825378

James A Morone

{"title":"Medicare in Treacherous Markets: From Community Bake Sales to Private Equity.","authors":"James A Morone","doi":"10.1215/03616878-11825378","DOIUrl":"https://doi.org/10.1215/03616878-11825378","url":null,"abstract":"Medicare's 60th birthday marks a shocking milestone for social democrats: More than half of all beneficiaries are signed up with private insurance plans that routinely deny payments. This paper flips the focus from the government program itself to the broader health care markets in which Medicare operates. I show how Medicare has lived through four very different health market eras. Each involves new kinds of medical institutions, new financial logics, and new thinking about what markets are and what role they ought to play in the program. First, during the long battle over Medicare, government programs and markets were (quite mistakenly) viewed as simple opposites. Second, in the 1970s, a new view emerged: Competition between HMOs would provide enrollees choice of providers, enhancing quality and lowering costs. Third, in the 1980s, Republicans pressed market choices into Medicare - drawing on rhetorical images from a bygone era; as conservatives were imagining medical markets, corporations arrived, asserted vast controls over medicine, and redirected consumer choice itself -- from selecting health providers to picking between insurance plans. Finally, beginning in the 2000s, private equity poured into health care and, once again, transformed the market. By Medicare's 60th birthday, enrollees found themselves in turbulent new era as health care in America was growing increasingly monetized.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528034","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

Consequences of Medicare Advantage for Beneficiaries and Politics: Revisiting The Delegated Welfare State.

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-02-28 DOI: 10.1215/03616878-11825370

Andrea Louise Campbell, Kimberly J Morgan

{"title":"Consequences of Medicare Advantage for Beneficiaries and Politics: Revisiting The Delegated Welfare State.","authors":"Andrea Louise Campbell, Kimberly J Morgan","doi":"10.1215/03616878-11825370","DOIUrl":"https://doi.org/10.1215/03616878-11825370","url":null,"abstract":"The Delegated Welfare State (Morgan and Campbell 2011) explored the causes and possible consequences of the 2003 Medicare reform boosting private managed care plans in the delivery of Medicare benefits. In this paper, we review scholarship on beneficiary experience (access, costs, outcomes) and political feedbacks arising from the delegated governance reform to evaluate whether predictions about consumer behavior and policy entrenchment have manifested. We find that beneficiary experiences and satisfaction do not differ significantly between Medicare Advantage and traditional Medicare, and MA plans' managed care techniques have cut per beneficiary spending. However, MA remains costlier to the federal government, per beneficiary, because of the outsized payments received by plan providers. Officials have failed to rectify these overpayments because of policy feedback effects - the empowerment of lobbying groups with a stake in the program and beneficiary support for it. Growing dependence on private plans to deliver health insurance for a large and politically influential constituency, senior citizens, has rendered government officials and elected politicians reluctant to imperil this market and the happiness of beneficiaries.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528017","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

The Evolution of Medicare: Challenges, Responses, and Prospects.

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-02-28 DOI: 10.1215/03616878-11830274

Sherry Glied, Richard Frank, Brendan Lui

{"title":"The Evolution of Medicare: Challenges, Responses, and Prospects.","authors":"Sherry Glied, Richard Frank, Brendan Lui","doi":"10.1215/03616878-11830274","DOIUrl":"https://doi.org/10.1215/03616878-11830274","url":null,"abstract":"The Medicare program has provided a near-universal source of health care coverage for America's elderly since 1965. Over its 60-year history, the program has evolved to cover a greater share of the population and pay for an increasing share of the nation's health care bills. As Medicare has grown, so too have its challenges. The traditional Medicare program has failed to keep pace with a rapidly changing health care sector and demographic shifts. Constrained by its own benefit design, Medicare has allowed privately-contracted health plans (Medigap, Medicare Advantage) to provide much needed yet inadequate remedies to the program's shortcomings. After briefly recounting Medicare's origins, we discuss how the program's founding statutes have hindered its ability to respond to new and growing challenges along the dimensions of cost-sharing, cost containment, and benefit design. We then propose a three-pronged approach to reforming Medicare's benefit structure. We argue that a simplified enrollment process, a single benefit that brings together the program's constituent parts (Part A, Part B, and Part D), and a new organizational structure for care delivery based on the program's experience with Accountable Care Organizations (ACOs), will together create a robust foundation that can sustain the Medicare program into the future.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528036","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

Medicare at 60: A Popular Program Facing Challenges.

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-02-28 DOI: 10.1215/03616878-11825362

Tricia Neuman, Jean Fuglesten Biniek, Juliette Cubanski

{"title":"Medicare at 60: A Popular Program Facing Challenges.","authors":"Tricia Neuman, Jean Fuglesten Biniek, Juliette Cubanski","doi":"10.1215/03616878-11825362","DOIUrl":"https://doi.org/10.1215/03616878-11825362","url":null,"abstract":"As Medicare approaches its 60th anniversary, it almost goes without saying that the program is both popular and successful. Medicare provides health insurance coverage to 67 million older adults and people with disabilities. Medicare is viewed favorably by Democrats, Republicans, and Independents. Medicare has also helped to extend life expectancy and, in conjunction with the Civil Rights Act of 1964, narrow disparities in care. It is a vital source of revenue for hospitals, physicians and other health care providers, and health insurers and is an essential component of health and retirement security in the U.S. These are among the reasons why Medicare is often considered a third rail in politics. Medicare also faces challenges stemming from the growing role of private plans, demographic shifts, and rising health care costs. This paper examines these challenges by focusing on three fundamental questions. First, what are the implications of the transformation that is taking place with private insurers playing a more dominant role in providing Medicare benefits? Second, what changes may be important to address the gaps in covered benefits and related affordability challenges? Third, how can Medicare be sustained to finance care for current and future generations?","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528020","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