Perspective

Medicaid Section 1115 demonstration projects are widely used to test innovative policies but are subject to “budget neutrality” limits so that federal expenditures do not exceed what the federal government would have spent if the project was not adopted. More

Racial equity impact assessments (REIAs) are used by local governments to integrate equity considerations into policymaking and decision-making processes by evaluating potential impacts of proposed legislation before enactment. More

From 2021 to 2025, federal nutrition assistance policy in the United States shifted rapidly from expansion to contraction, with major implications for food insecurity, diet quality, and chronic disease risk. More

The United States incarcerates more people per capita than any peer nation, and its criminal justice system disproportionately impacts Black, Indigenous, and other communities of color. More

In April 2018, a naked man with an AR-15 burst into a Waffle House restaurant in Nashville, Tennessee. Firing at random, he murdered four people and gravely injured five more before escaping into the night. More

Edmund Pellegrino warned about the growing commodification of health and health care in the United States. After twenty-five years, it is worth revisiting Pellegrino’s critique and examining this critique in the current era. More

The global wellness industry has multifaceted impacts on health and well-being, including through the sale and consumption of wellness products, the provision of health information to consumers, and the promotion of specific norms and values. Despite its growing prominence, the wellness industry and its impacts on health and policymaking remain understudied. This article examines how the wellness industry operates as a commercial, social, and political determinant of health. More

The so-called One Big Beautiful Bill Act signed into law by President Trump on July 4, 2025 will cut $1 trillion from federal health care programs over the coming decade and cause 10 million individuals to become uninsured according to the Congressional Budget Office. Most analyses of the bill’s impacts have assumed they would be the inverse of those documented from previous coverage expansions. An examination of past coverage cuts might yield additional insights into the probable impacts of this legislation on the medical care and health of the needy. More

Disparities in health often arise due to unfair or unjust social arrangements making them inequities. These social arrangements are codified through structures—laws, policies, regulations, practices, and norms. More

The One Big Beautiful Bill Act, enacted on July 4, 2025, established the first nationwide Medicaid work requirement, replacing prior state-specific Section 1115 demonstrations with a uniform federal standard More