Children and Families

Post-ACA, More Than One-third Of Women with Prenatal Medicaid Remained Uninsured Before or After Pregnancy

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.

Medicaid Expansion Increased Preconception Health Counseling, Folic Acid Intake, and Postpartum Contraception

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.

Expanded Job Protection Improves Racial and Socioeconomic Equity of Parental Leave Access

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.

Combating Unstable Schedules for Low-wage Workers in Oregon

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.

Among Low-Income Women In San Francisco, Low Awareness of Paid Parental Leave Benefits Inhibit Take-Up

Paid family leave policies have the potential to reduce health disparities, yet access to paid leave remains limited and unevenly distributed in the United States. The US is the only OECD country that does not provide paid leave for new parents, and just 8 states and the District of Columbia have passed partially-paid family leave policies. In a new paper, Julia Goodman of the OHSU-PSU School of Public Health, Will Dow of UC Berkeley, and Holly Elser of Stanford University examine the impact of the 2017 San Francisco Paid Parental Leave Ordinance (PPLO), the first in the US to provide parental leave with full pay. 

Income Support and Children's Health Trajectories

Approximately 16 percent of children in the U.S. live in families with incomes below the federal poverty threshold, potentially creating negative long-term effects that are experienced over the life-course. The Supplemental Security Income (SSI) program provides cash assistance to low-income children with disabilities, expanding family budgets and potentially allowing low-income parents to better protect the health of vulnerable children. However, few studies have evaluated the impact of this policy.

The Effects of Income on Children’s Health: Evidence from Supplemental Security Income Eligibility under New York State Medicaid

Approximately 16 percent of children in the U.S. live in families with incomes below the federal poverty threshold. This early-life exposure to poverty may have negative long-term health effects. In a new working paper, Hansoo Ko, Renata Howland, and Sherry Glied of the P4A Research Hub at New York University Robert F. Wagner Graduate School of Public Service, estimate the causal impacts of the Supplemental Security Income program on child health outcomes and medical expenditures.

Commentary

As shoppers prepare for the holidays with trips to the mall, supermarket, and big box stores, many workers who stock the shelves and work the registers are scrambling to piece together child care to match their unpredictable work schedules.

Commentary

A unique partnership in Minnesota is linking data about health, human services, housing, and criminal justice to increase our understanding of risk factors and protective factors for children entering foster care. But how do we ensure we tailor our research approach to fit the complicated lives of real parents, caregivers, and children?