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Medicaid is the largest payer of substance use disorder (SUD) treatment in the United States. Managed care plays an important role, administering benefits for more than 80% of Medicaid enrollees. While state governments have enacted coverage requirements for SUD treatment medications that managed care plans must follow, the extent to which managed care coverage policies align with these rules remains largely unknown. More

Recent studies have linked the rising rates and growing disparities in working-age mortality partly to changes in US states’ policy contexts since the 1980s. Yet, such studies largely rely on measures of states’ policy contexts, or “policy indices,” that were created for other purposes, are not regularly updated, and use complex methods that can be difficult to interpret and replicate. Further elucidating the mortality trends and disparities would benefit from a policy index that is designed for population health analyses and a clearer understanding of the utility of such indices. More

In response to the high cost of state-run Medicaid programs, the 1993 Medicaid estate recovery policy was established to enable states to recover assets from the estates of beneficiaries after death. Estate recovery may trigger behavioral responses from older adults who may no longer view real estate as an attractive asset, may borrow money from home equity to cover the cost of increasing care needs, or may avoid enrolling in Medicaid altogether. More

Four decades ago, I and Gerald Markowitz published an article in the American Journal of Public Health that attracted a fair amount of attention. The article was about the history of the introduction of tetraethyl lead into gasoline in the 1920s. The article detailed the controversy over putting lead, even then a known industrial poison and neurotoxin, into the gasoline that was powering the new automobile, particularly those that were produced by the General Motors Company. More

To make a point, the Marxist sociologist Erik Olin Wright (1997) once borrowed a character from the 1960s comic strip Lil’ Abner: a big blobby… More

At the very end of the Clinton Administration, Republican Congresswoman JoAnne Emerson inserted a two-paragraph provision into the 2001 Treasury and General Government Appropriations Act. These paragraphs would become known as the Data Quality Act (as well as the Information Quality Act) and its passage represented a major victory for industries – including the tobacco and chemical industries – regulated by the federal government. More

Affordability pressures increasingly shape health risk in the United States, influencing both the upstream conditions that sustain health and the downstream ability to access health promoting resources. Financial stability is a key driver of health, affecting patterns of health, health care use, and the tradeoffs people must make among competing needs. The economic policy landscape aimed at improving financial security for Americans is expansive, complex, and often difficult to organize, making it challenging to discuss how different policies influence financial resilience and population health. We propose the Earn–Keep–Grow framework as a practical way to organize and guide discussion of these policies in population health research and policy decision-making. More

Public health science gains in the last quarter century in the United States have been formidable due to a focus on structural and social determinants of health, thereby enhancing understanding of the role of inequitable policies in shaping health inequities and inequitable access to ameliorative resources. More

Context: Before the COVID-19 pandemic, persons with pregnancy Medicaid coverage were typically disenrolled after 60 days postpartum, at which point they could retain Medicaid only if they qualified through another eligibility category (most commonly as a parent). The March 2020 Families First Coronavirus Response Act (FFCRA) extended postpartum Medicaid coverage by requiring states to pause disenrollment in exchange for enhanced federal funding. More

Mental health among US working-age adults notably worsened during the COVID-19 pandemic, following a steady decades-long decline. The impact of states’ COVID-19 policies on mental health has received much attention; however, less is known about the impact of a broader set of long-standing and overarching state policy contexts. More