Journal of Health Politics Policy and Law最新文献_第2页

MAHA Won't Make Americans Healthy Again: The Politicization of U.S. Federal Health Agencies During the Second Trump Administration. MAHA不会让美国人再次健康：特朗普第二任期美国联邦卫生机构的政治化。

IF 2.8 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-10-08 DOI: 10.1215/03616878-12262680

Pamela Herd

引用次数: 0

Section 1115 Substance Use Disorder Waivers: Opportunities and Limitations. 第1115节物质使用障碍豁免：机会和限制。

IF 2.8 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-08-11 DOI: 10.1215/03616878-12166733

Thomas Statchen, Harold Pollack, Amanda J Abraham, Christina M Andrews, Colleen M Grogan

{"title":"Section 1115 Substance Use Disorder Waivers: Opportunities and Limitations.","authors":"Thomas Statchen, Harold Pollack, Amanda J Abraham, Christina M Andrews, Colleen M Grogan","doi":"10.1215/03616878-12166733","DOIUrl":"https://doi.org/10.1215/03616878-12166733","url":null,"abstract":"In 2022, 48.7 million people in the United States (17.3% of the population aged 12 or older), met criteria for substance use disorder (SUD). Nearly 40% of people with opioid use disorder (OUD) are Medicaid recipients, making Medicaid the largest single source of OUD treatment insurance coverage. Despite this crucial importance, there remain two major barriers to expanding access to treatment for persons with SUD baked into the program: the Institutions for Mental Diseases (IMD) exclusion and the Medicaid inmate exclusion. In this essay we first provide a timeline of these two waiver reforms to illustrate the variation in waivers over time and across states. Second, we assess the evidence to date on how well the SUD waivers are working to accomplish these goals in states that have adopted them. This review will focus on the SUD waivers that address the IMD exclusion, because the MIE waivers are too new for any systematic evidence. We will then consider outstanding implementation challenges and policy risks associated with the IMD and MIE waivers, and conclude by considering challenges these waivers do not address and therefore demand particular attention to properly serve persons living with SUD.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818342","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

What Information Elicits Policy Enthusiasm? Older Americans, the ACA, and Medicare. 哪些信息能激发政策热情？老年美国人，ACA和Medicare。

IF 2.8 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-08-11 DOI: 10.1215/03616878-12166741

Simon F Haeder

{"title":"What Information Elicits Policy Enthusiasm? Older Americans, the ACA, and Medicare.","authors":"Simon F Haeder","doi":"10.1215/03616878-12166741","DOIUrl":"https://doi.org/10.1215/03616878-12166741","url":null,"abstract":"Context: Target populations do not always recognize policy benefits. This may be particularly true when policy design, informational environment, or political conflict make a policy's benefits difficult to discern, which is the case for the Affordable Care Act (ACA). While many groups benefited from the ACA, attitudes of seniors, one important target population of the ACA, remain unexplored.Methods: A survey of 1,206 Americans age 65+ was fielded in the summer of 2021 to assess the effect of three informational treatments about the ACA's benefits including extending the life of the Medicare trust funds, filling the Medicare Part D donut hole, and reducing the number of uninsured on the ACA's favorability and attitudes about its future and party leadership on healthcare.Findings: Priming individuals about the ACA's benefits improved its favorability, particularly for subgroups generally opposed to the ACA such as Republicans and those high in racial resentment. Attitude changes about the future of the ACA were limited to benefits directly focused on seniors. There were no broader spillover effects on attitudes about partisan healthcare leadership.Conclusions: The findings have implications for research on the ACA, on policy feedback effects, on self-interest, and on priming effects.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818343","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

Democracy, Trust, and Political Orientation: Disentangling Mechanisms Shaping Individuals' Vaccine Attitudes. 民主、信任和政治取向：塑造个人疫苗态度的解开机制。

IF 2.8 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-08-11 DOI: 10.1215/03616878-12166725

Marcello Antonini, Renu Singh, Alessia Melegaro, Aleksandra Torbica, Jeremy Keith Ward, Chiara Berardi, Katie Attwell, Adrian Kellner, Eli Feiring, Terje P Hagen, Mesfin Genie, Liubovė Murauskienė, Neil McGregor, Ana Rita Sequeira, Dongyue Yang, Francesco Paolucci

{"title":"Democracy, Trust, and Political Orientation: Disentangling Mechanisms Shaping Individuals' Vaccine Attitudes.","authors":"Marcello Antonini, Renu Singh, Alessia Melegaro, Aleksandra Torbica, Jeremy Keith Ward, Chiara Berardi, Katie Attwell, Adrian Kellner, Eli Feiring, Terje P Hagen, Mesfin Genie, Liubovė Murauskienė, Neil McGregor, Ana Rita Sequeira, Dongyue Yang, Francesco Paolucci","doi":"10.1215/03616878-12166725","DOIUrl":"https://doi.org/10.1215/03616878-12166725","url":null,"abstract":"Context: In recent decades, many countries experienced a reduction in the quality and functioning of democratic institutions and norms, accompanied by rising social distrust and opposing political views. The decline in vaccine confidence might be linked to these trends. This study explores the political factors influencing individual attitudes towards vaccination across 22 upper-middle-income and high-income countries, examining the interaction between political orientation, trust in public health authorities, and levels of democracy.Methods: Using the VaxPref database, encompassing demographically representative data from 50,242 respondents collected between July 2022 and June 2023, our analysis operates on three levels: pooled sample, democracy groups, and country-specific analyses.Results: We found that higher democracy scores generally correlated with lower levels of vaccine scepticism. People at the centre and on the right of the political spectrum expressed more scepticism towards vaccines overall. However, trust in public health authorities emerged as the determinant which explains the largest variation in vaccine attitudes.Conclusions: Our findings suggest a greater effectiveness of democratic systems in fostering vaccine confidence, and the need to depoliticise vaccination efforts. Building and maintaining trust in scientific information and technical expertise is critical. Blunt measures like vaccination mandates may not sustain long-term confidence, particularly in democratic contexts. Effective interventions should prioritise comprehensive school-based education to promote preventive health behaviours, coupled with trust-enhancing targeted communication strategies.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818330","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

Lots of Pain for Little Gain: Three Decades of Medicaid Estate Recovery. 多痛苦少收获：三十年的医疗补助遗产恢复。

IF 2.8 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-08-11 DOI: 10.1215/03616878-12166749

Amanda Spishak-Thomas, Emma Sandoe, Heather Howard

{"title":"Lots of Pain for Little Gain: Three Decades of Medicaid Estate Recovery.","authors":"Amanda Spishak-Thomas, Emma Sandoe, Heather Howard","doi":"10.1215/03616878-12166749","DOIUrl":"https://doi.org/10.1215/03616878-12166749","url":null,"abstract":"Since Congress enacted Medicaid estate recovery into law in 1993, there have been few changes to the policy and little research to investigate its effectiveness. Under Medicaid estate recovery - a response to the rising and uncertain costs associated with long-term custodial care among a rapidly aging American population - states have the right to track former Medicaid beneficiaries' assets and seek recovery from their estate after their death. While it makes an insignificant dent in state budgets, Medicaid estate recovery nonetheless can have a lasting impact on the lives of families subject to its repayment requirements. For low-income families where homeownership is their primary source of wealth, policies aimed at homeowners may exacerbate longstanding disparities in wealth and disproportionately burden Black and Hispanic families. Recently, some states have initiated policy changes to address problems with Medicaid estate recovery and similar legislation also has been introduced in Congress. Such reforms, if more widely adopted, may improve the financial circumstances of surviving family members of deceased Medicaid beneficiaries.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818331","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

Runaway Polarization Is Making Us Sick. Social Science Could Offer an Antidote. 失控的两极分化正在让我们生病。社会科学可以提供解药。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-06-20 DOI: 10.1215/03616878-11995120

Timothy Callaghan, Matt Motta

{"title":"Runaway Polarization Is Making Us Sick. Social Science Could Offer an Antidote.","authors":"Timothy Callaghan, Matt Motta","doi":"10.1215/03616878-11995120","DOIUrl":"10.1215/03616878-11995120","url":null,"abstract":"Public health in the United States has become deeply polarized. Runaway political polarization is increasingly influencing both American's health attitudes (e.g. supporting health policies and candidates that are hostile to public health) and behaviors (e.g., whether people take action to protect themselves and others from infectious diseases). In this manuscript, we detail the growing partisan polarization of public health over time, examining partisan polarization and its policy consequences. We then propose a three-pronged path for better understanding and overcoming polarization in health and medicine. First, we call for additional social-scientific research on public health polarization. We highlight the need for health data that includes measures of partisanship as well as the need for appropriate sources of funding to study public health polarization. Second, we point to the need for better health communication interventions to confront polarization that are both scalable in real-world settings and likely to be supported by community partners concerned about appearing 'political' in their efforts at health messaging. Finally, we discuss the vital role of clinicians in addressing polarization's impact on health, suggesting strategies for patient engagement and the need for research on the bioethical implications of discussing partisan issues during clinical encounters.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334468","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 Changing Politics of Guns in America. 美国枪支政治的变化。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-06-20 DOI: 10.1215/03616878-11995176

Caitlin L McMurtry

{"title":"The Changing Politics of Guns in America.","authors":"Caitlin L McMurtry","doi":"10.1215/03616878-11995176","DOIUrl":"10.1215/03616878-11995176","url":null,"abstract":"During the pandemic, rates of suicide among adolescents of color rose sharply and firearm injuries became the leading cause of death among children and youth. At the same time, firearm sales soared, changing the profile of American gun owners, and the political landscape of firearms altered amid groundbreaking Supreme Court decisions, the National Rifle Association's collapse, and the proliferation of firearm deregulation policies. This new period of gun politics has coincided with larger societal phenomena, including growing distrust of government, of institutions, and of each other. Together, they demonstrate an urgent need to rethink our messaging strategy around gun violence. Specifically, while trust in health institutions and experts remains low, invoking the language of public health may be not only insufficient, but counterproductive. Until public health, as a discipline, engages proactively with the social and political aspects of firearm ownership and understands guns as means of replacing fear and uncertainty with strength and self-sufficiency, the field may find little success in reducing firearm deaths. This essay discusses changes to the U.S. gun landscape before, during, and after the pandemic, the Trump administration's approach to the Second Amendment, and what it all means for the future of gun politics in America.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334471","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

Using New Techniques to Examine the Past: A Computational Assessment of the First 50 Years of the Journal of Health Politics, Policy and Law. 使用新技术来检查过去：对卫生政治，政策和法律杂志前50年的计算评估。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-06-20 DOI: 10.1215/03616878-11995192

Sarah E Gollust, Yujin Kim, Paul Espinoza Kissell, Erika Franklin Fowler

{"title":"Using New Techniques to Examine the Past: A Computational Assessment of the First 50 Years of the Journal of Health Politics, Policy and Law.","authors":"Sarah E Gollust, Yujin Kim, Paul Espinoza Kissell, Erika Franklin Fowler","doi":"10.1215/03616878-11995192","DOIUrl":"10.1215/03616878-11995192","url":null,"abstract":"A rigorous investigation of the past 50 years of scholarship in the Journal of Health Policy, Policy and Law requires the application of large-scale computational text tools. We utilized four strategies to analyze research articles (N = 1,532): keyword searching, named entity recognition, unsupervised topic modeling, and use of large language modeling. We examined geographies, main topics and sub-topics of articles over time; attention to equity/diversity, racism, women's health, and LGBTQ+ people; and authors' methodological approaches. Articles have examined a diversity of health policy topics, although most have concerned health care access and health insurance, and the majority are U.S.-based. Authors have consistently (more than 50% of articles) mentioned issues of health equity and health disparities, across the 50 years. They have applied a range of methodological approaches, with empirical legal and policy analyses the most prominent; qualitative approaches have been consistent, while quantitative articles have seen an increase in the past decade. Findings demonstrate the utility of computational methods in future applications for health policy and politics scholarship.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334492","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

Same as It Ever Was? Persistence and Transformation in US Health Care Policy. 和以前一样吗？美国医疗保健政策的坚持与转变

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-06-20 DOI: 10.1215/03616878-11995208

Jonathan Oberlander

引用次数: 0

Value-Based Payment in Medicare: Progress, Challenges, and Future Directions. 医疗保险中基于价值的支付：进展、挑战和未来方向。

IF 3.3 3区医学

Journal of Health Politics Policy and Law Pub Date : 2025-06-20 DOI: 10.1215/03616878-11995200

Jose F Figueroa, Ciara E Duggan, Karen E Joynt Maddox

{"title":"Value-Based Payment in Medicare: Progress, Challenges, and Future Directions.","authors":"Jose F Figueroa, Ciara E Duggan, Karen E Joynt Maddox","doi":"10.1215/03616878-11995200","DOIUrl":"10.1215/03616878-11995200","url":null,"abstract":"Despite having the highest healthcare spending globally, the United States lags in key health outcomes compared to peer nations. Over recent decades, this concerning disconnect between spending and outcomes has spurred substantial national reforms focused on promoting \"value\" over \"volume\" of care, prompting the development of numerous value-based payment models. In this analysis, we provide an overview of the experience with value-based payment efforts in the United States, particularly within the Medicare program. We outline and evaluate four main value-based care paradigms: public reporting programs, pay-for-performance models, episode-based payment models, and population-based payment models. Across these models, we argue that there has been mixed success in achieving cost reduction and quality improvements. While some episode-based and population-based models have shown modest savings, the overall efficacy of value-based care reforms remains suboptimal, and many models have yielded unintended consequences that have exacerbated existing health disparities. Considering this evidence alongside the current and emerging threats to value-based payment efforts, we identify several key areas for improvement across these models and discuss a path forward for strengthening value-based payment and delivery system reforms, highlighting key strategies to ensure that future value-based payment models achieve the goals of fostering high-quality, cost-effective, and equitable care.","PeriodicalId":54812,"journal":{"name":"Journal of Health Politics Policy and Law","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334493","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