Evidence

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Since the early 1990s, Medicaid has been critical in providing insurance coverage for pregnant women with low incomes in the United States - pregnancy-related Medicaid coverage is available to women with incomes up to 200 percent of the federal poverty level in most states. Because pregnancy-related Medicaid eligibility is almost always more generous than eligibility for other adults, many women with low incomes not otherwise eligible for Medicaid gain coverage during their pregnancies but then lose that coverage sixty days after delivery, when their pregnancy-related eligibility expires. The American Rescue Plan Act of 2021 included an option for states to extend Medicaid coverage for twelve months postpartum. While the ACA provided coverage improvements for pregnant women outside of pregnancy, especially in states expanding Medicaid, many low-income women remain uninsured before or after their pregnancies. Building on existing studies tracking changes in Medicaid coverage and uninsurance under the law, researchers Emily M. Johnston, Stacey McMorrow, Clara Alvarez Caraveo and Lisa Dubay examined data for new mothers with Medicaid-covered prenatal care in this study published in Health Affairs.

Our homes and neighborhoods have a powerful impact on our physical and mental health, with the potential to exacerbate chronic and acute health problems and cost the U.S. billions of dollars annually. Sherry Ahrentzen and Lynne Dearborn investigated how the Low-Income Housing Tax Credit (LIHTC), the nation’s largest source of funding for the development and preservation of affordable rental housing, can contribute to shaping a healthier housing stock.

The period before pregnancy is critically important for the health of a woman and her infant, yet not all women have access to health insurance during this time. Rebecca Myerson of the University of Wisconsin-Madison, Samuel Crawford of the University of Southern California, and Laura R. Wherry of New York University evaluated whether increased access to health insurance under the Affordable Care Act (ACA) Medicaid expansions affected ten preconception health indicators, including the prevalence of chronic conditions and health behaviors, birth control use and pregnancy intention, and the receipt of preconception health services.

Paid family and medical leave has important health benefits for parents and their children, but access to job-protected leave is limited and highly disparate in the United States. Increasingly, state and local governments have established policies such as paid leave to support parents and other caregivers. While these policies have been crucial in enabling more workers to take leave, their effects have been weakened due to only partial coverage of job protection laws. As part of their ongoing work evaluating the 2017 San Francisco Paid Parental Leave Ordinance, investigators Julia M. Goodman (Oregon Health & Science University/Portland State University) and William H. Dow (University of California, Berkeley) published an issue brief examining paid leave protections in the California Bay Area.

The advent of just-in-time scheduling technology and practices in the mid-1990s has led to increased schedule instability, resulting in a growing movement to address the need for predictable, stable schedules for workers paid low wages. Unstable schedules have been associated with earnings instability, increased stress and fatigue, sleep irregularity, and worse mental health outcomes for workers.  In this report, P4A researchers Amelia Coffey, Eleanor Lauderback and H. Elizabeth Peters, along with their partners at the University of Oregon’s Department of Sociology Lola Loustaunau, Larissa Petrucci, Ellen Scott and Lina Stepick, examine Oregon’s implementation of S.B. 828, the first statewide predictive scheduling law in the nation, in its first year.