Social and Behavioral Sciences Commons^™

Adult Day Services In Maine: Benefits, Challenges, And Opportunities, Elizabeth Gattine Jd, Eileen Griffin Jd, Kimberly I. Snow Mhsa, Ba

Disability & Aging

In Maine and nationally, adult day services tend to be underfunded and underutilized compared to other types of long term services and supports (LTSS). In part, investment in adult day services is hampered by a lack of standardized data collection and limited research on issues of accessibility, cost-effectiveness, and the impact of adult day services on the broader health system. Lack of uniformity in state regulatory frameworks for licensing, program design, service delivery, and other administrative requirements further complicates cross-state comparisons. Considering these limitations, a key goal of this report is to provide a more detailed and comprehensive understanding of …

Combatting Rising Healthcare Costs For Healthier Adults, Alejandra Muñoz-Rivera

Social Policy Institute Research

In 2020, healthcare expenditures averaged $12,530 per person, up 9.7% from 2019. In 2018, 19% of U.S. households had medical debt with $2,000 being the median amount owed. Over half of adults between 18 to 64 years of age are estimated to experience some form of medical financial hardship including medical bills or debt, stress about medical bills, and delaying or forgoing treatment specifically due to cost. In a 2022 survey of 140 Medicaid and Marketplace members by researchers from the Social Policy Institute (SPI) and the Centene Center of Health Transformation, one-third of respondents reported having unpaid medical bills. …

Coverage Impacts Of Work Requirements From The Arkansas Medicaid Program, Brett D. Huettner

ETD Archive

I examine changes in Medicaid coverage and insurance status surrounding a work requirement policy implemented within the Arkansas Medicaid demonstration waiver. The policy applied to able-bodied, childless adults, aged 30 to 49, not enrolled as students, and was effective from 2018 to 2019. Eligibility was conditional on policy compliance. Taking a sample from the IPUMS American Community Survey database, I use triple-differences modeling to compare Arkansans subject to the policy with unaffected Arkansans and individuals from a set of control states. I find that the policy pilot group in Arkansas was less likely to be insured or have Medicaid coverage …

The Effect Of The Affordable Care Act On Opioid Overdose Mortality, Caleb Jordan

All Theses

The opioid epidemic is an ongoing health crisis in the United States, claiming the lives of thousands over the past two decades. In 2014, provisions of the Affordable Care Act expanding Medicaid officially came in effect, extending healthcare to millions of people in the United States. However, Medicaid expansion was optional for states, so some states greatly expanded healthcare to low-income people while others did not. People in expansion states gained more affordable access to prescription drugs and treatment centers, making opioids easier to obtain and addictions more affordable to treat. This makes the effect of the Affordable Care Act …

“The Worst Part About My Pregnancy Was Stuff That Didn’T Have To Do With My Pregnancy”: Medicaid Beneficiaries’ Pregnancy Intentions & Experiences In South Carolina, Andrew Michael Chen

Senior Theses

Low-income women and women of color experience adverse birth outcomes at disproportionately higher rates in the United States than most people who give birth. This thesis examines individual interviews conducted with 30 low-income women whose most recent birth was covered by Medicaid, the United States’ largest means-tested public health insurance program. The aim of this thesis is to examine how the women in the study thought about pregnancy, and how they described their intentions to become or avoid becoming pregnant at various times in their life. While public health researchers often frame pregnancy as an event that is either intended …

Mental Health Is Wealth Too: Did The Affordable Care Act Medicaid Expansion Improve Mental Health Outcomes?, Dereck Wang

Honors Theses

The ongoing COVID-19 pandemic has greatly exacerbated mental health, which has long been a growing problem in the United States; poor mental health not only jeopardizes the well-being of Americans but also has severe implications for America’s economy. Not only do mental health conditions have significant costs of treatment, but the absenteeism, presenteeism, early retirement, and mortality stemming from poor mental health also severely impact productivity. One health policy that could alleviate this problem is Medicaid expansion. The Affordable Care Act gave states the choice to expand Medicaid eligibility for individuals with incomes up to 138% of the federal poverty …

Political, Racial, And Household Income Barriers For Access To Healthcare In Illinois Counties, Kennedy Bray '23

Student Publications & Research

Access to health care impacts many people throughout the United States, as it restricts their ability to solve their health concerns. People who have the highest risk of a lack of access include people who are uninsured, people a part of a specific social class, or people belonging to a specific political party. In a particular geographical region, these factors could lead to groups of people suffering because of circumstances that they cannot control in their region. In my project, I determine how better access to healthcare and the percentage of people insured are affected by a measurement of the …

County Social Isolation And Opioid Use Disorder Among Older Adults: A Longitudinal Analysis Of Medicare Data, 2013–2018, Tse-Chuan Yang, Carla Shoff, Seulki Kim, Benjamin A. Shaw

Department of Sociology: Faculty Publications

This study aims to fill three knowledge gaps: (1) unclear role of ecological factors in shaping older adults’ risk of opioid use disorder (OUD), (2) a lack of longitudinal perspective in OUD research among older adults, and (3) underexplored racial/ethnic differences in the determinants of OUD in older populations. This study estimates the effects of county-level social isolation, concentrated disadvantage, and income inequality on older adults’ risk of OUD using longitudinal data analysis. We merged the 2013–2018 Medicare population (aged 65+) data to the American Community Survey 5-year county-level estimates to create a person-year dataset (N = 47,291,217 person-years) and …

An Analysis Of The 2014 Medicaid Expansion On New York And California's Maternal Mortality Rate, Reshanna Jagroo

Honors Undergraduate Theses

This thesis seeks to investigate the 2014 Medicaid expansion’s effect on maternal mortality rates for New York and California. The CDC reported in 2019 that maternal mortality rates have been increasing. These findings are concerning for mothers and are a problem for developed nations like the United States with improved healthcare. Furthermore, women of color are disproportionately affected relative to white women. Previous research has indicated that healthcare expansions positively affect decreasing death rates among pregnant women.

In this study, I investigate how increased access to healthcare through the 2014 Medicaid expansion under the Affordable Care Act affects maternal mortality …

An Analysis Of Tennessee’S New Medicaid Waiver: Tenncare Iii, Mary Moore

MPA/MPP/MPFM Capstone Projects

Medicaid is a federal-state partnership to provide health coverage benefits to certain vulnerable groups. Each state is responsible for administering its own Medicaid program in accordance with certain federal rules which include mandatory benefits for covered groups, namely, low-income children and their parents and aged, blind, and disabled individuals. There are additional groups which may be covered by Medicaid at the discretion of the state. As a partnership, the federal government covers a certain percentage of Medicaid expenditures in each state. This agreed upon rate is the federal medical assistance percentage or FMAP. Tennessee’s FMAP is set at 66.1% for …

Medicaid Expansion: The Choice Afforded To States By The Affordable Care Act, Robert M. Hatfield

MPA/MPP/MPFM Capstone Projects

The issue I studied is the decision states have been afforded to expand Medicaid with the Affordable Care Act (ACA). I was curious to determine the health and economic impact on states that have and have not chosen to expand Medicaid. Specifically, I targeted Kentucky (expansion state) and Tennessee (non-expansion state). Tennessee and Kentucky are similar populations, have similar political inclinations, and are both very rural states. At its core, Medicaid expansion is an opportunity to improve health for lower-income and disabled Americans. However, there are economic implications associated with Medicaid expansion as well. The goal of this research is …