Public Health

Assessment of Perceptions of the Public Charge Rule Among Low-Income Adults in Texas

A recent expansion of the federal “public charge” rule allows the government to deny immigrants permanent residency based on their income or health status or if they participate in programs that did not previously trigger the rule, such as Medicaid or the Supplemental Nutritional Assistance Program [SNAP]. Critics contend that this will dissuade individuals from participating in programs or obtaining medical care. In this JAMA Network Open paper, Benjamin D. Sommers, Heidi Allen, Aditi Bhanja, Robert J. Blendon, John Orav, and Arnold M. Epstein examine perceptions of the new public charge rule and its potential impacts on public program participation and medical care among low-income adults in Texas.

Commentary

Even as the COVID-19 pandemic raged, state legislators continued to quietly pass laws that consolidate power in state capitals and take away local governments’ authority to protect public health. Oklahoma is the latest example.

Does Private Insurance Provide More Medical Care?

Ten years after the passing of the Affordable Care Act—the most comprehensive health care reform of the past half-century—most of the previously uninsured continue to lack coverage. Policymakers and members of the public have expressed growing support for expanding the role of public financing of health care. The “public option” and “Medicare for All” have emerged as important contenders for health policy reform. Both policies are rooted in widening access to the lower prices of the public system to make health care more affordable for all.

Commentary

To find out whether California's 2016 repeal of non-medical exemptions was associated with an increase in uptake of vaccines required for school entry, P4A researchers at George Washington University evaluated California’s new policy and tracked vaccination rates from 2012 to 2017. While vaccination coverage rose, the policy came with unintended consequences.

The Effects of State Pre-emption of Local Smoking Restrictions on Health Disparities

Public health practitioners and tobacco control advocates agree that pre-emption (a higher level of government stripping lower levels of government of their authority over a specific subject matter) has an adverse impact on tobacco control efforts. Pre-emptive state laws may prohibit local tobacco control measures, such as restrictions on marketing and promotion of tobacco products, licensure of tobacco products, smoking in public or private sites, and on youth access to tobacco products.

Local Initiatives, State Pre-emption, and Public Health

State pre-emption is an emerging and highly contentious policy movement with potentially significant consequences on population health. Yet robust analyses to examine whether pre-emption affects health have yet to be conducted. Furthermore, pre-emption’s effect on geographic inequities in health has been largely neglected in policy debates. But it is becoming increasingly clear that state pre-emption laws could reshape the spatial distribution of health, with profound consequences for health care delivery systems and state and local budgets.

How the Opioid Epidemic Impacts Children

The impact of the opioid epidemic on children, their families, and on child-serving systems (early childhood education, schools, child welfare, etc.) is not well understood. This exploratory project will examine some of the most critical dimensions, urgent challenges, and important nuances for policymakers and others, drawing on a review of the existing literature and a deeper dive into two states at the forefront of the opioid epidemic.

The Potential Chilling Effects of the Public Charge Rule on Medical Care and Program Participation

In January 2020, the Supreme Court allowed the Department of Homeland Security to implement a new rule regarding the definition of “public charge.”  Our team is collecting primary data from two distinct populations to explore awareness of the public charge rule, sources of information about the rule, and how the rule may affect decisions on obtaining medical care and participating in public programs.